Lavikka, R H; Kyrö, R; Peltokorpi, A and Särkilahti, A (2019) Revealing change dynamics in hospital construction projects. Engineering, Construction and Architectural Management, 26(9), pp. 1946-1961. ISSN 0969-9988
Abstract
Purpose: Hospital construction projects often suffer from relatively late changes in the project lifecycle, which disrupt the project execution and impact project productivity. The purpose of this paper is to explore the root causes of changes in hospital construction projects. The paper aims to propose ways to prepare for the changes. Design/methodology/approach: The study focuses on changes during the construction of new hospital facilities. An explorative, case study research design is utilised. Five case projects from Finland, Sweden and the USA were selected for in-depth analysis. The primary data comprise semi-structured interviews, supported by secondary evidence such as change order documents. Findings: The findings reveal eight categories for change sources: contracts, and equipment and systems are reflective of the fast-paced healthcare technology and changing user requirements, while external environment comprises changes caused by both regulatory and physical environment. Changes in operations are reflected in the continuous development of treatment methods and processes. The user, owner, designer and contractor initiated changes represent the stakeholder influence. The paper makes a connection between these change sources and project complexity dimension. A framework for change dynamics is introduced, and product and process flexibility is suggested as a suitable method to prepare for and manage changes. Originality/value: The paper is the first to link construction changes to project complexity factors. The paper argues that changes, when managed appropriately, are not only necessary but also beneficial to large construction projects in a quickly changing environment. The findings guide project stakeholders in implementing project flexibility, in the product and process dimensions, which is a balancing force to project complexity.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | case study; construction; project management |
| Index terms: | project complexity, evidence, healthcare building construction, project stakeholder, documents, methodology, large construction project, interview, project management, dimension, hospital facility, dynamics, change order, designer, Sweden, research design, Finland, project lifecycle, productivity, owner, case study, user requirement |
| Subjects: | project management theory and practice, professional development, organizational theory, contractual condition, Geography, research methods, management, systems engineering, sociology, building construction, research design and methodology, project completion, user-centered design, profession, construction type, data collection methods, evaluation and assessment methods, health monitoring assessment and metrics |
| Topics: | Design Practice, Contract Administration, Business Strategy, Health and Safety, Geographical Context, Project Management, Research Practice, Engineering Principles, Information Management, Roles and Professions, Stakeholder Management, Construction Technology |
| Descriptive scope: | 5 PCTEA |
N.B. Descriptive scope is a count of how many of the five facets of empirical research are indicated by the words used in title, abstract and keywords. It is not intended as a judgement on the research; merely a count of the kind of word we would expect to indicate Phenomenon, Concepts, Theoretical framing, Empirical techniques, Analytical techniques. If all five are present, then a code of “5 PCTEA” will indicate this. If you feel the coding for this record is questionable, we welcome discussion around the terms we matched or the way we categorized them. The facet you would expect may not be coded, or a facet may be coded inappropriately. This can also bear on a larger question, of which facets should be treated as defining in construction management research. Please get in touch, and we will look at it. More details here