BackgroundSuccessful implementation of new methods and models of healthcare to achieve better patient outcomes and safe, person-centered care is dependent on the physical environment of the healthcare architecture in which the healthcare is provided. Thus, decisions concerning healthcare architecture are critical because it affects people and work processes for many years and requires a long-term financial commitment from society. In this paper, we describe and suggest several strategies (critical factors) to promote shared-decision making when planning and designing new healthcare environments.DiscussionThis paper discusses challenges and hindrances observed in the literature and from the authors extensive experiences in the field of planning and designing healthcare environments. An overview is presented of the challenges and new approaches for a process that involves the mutual exchange of knowledge among various stakeholders. Additionally, design approaches that balance the influence of specific and local requirements with general knowledge and evidence that should be encouraged are discussed.SummaryWe suggest a shared-decision making and collaborative planning and design process between representatives from healthcare, construction sector and architecture based on evidence and end-users’ perspectives. If carefully and systematically applied, this approach will support and develop a framework for creating high quality healthcare environments.

Purpose The purpose of this paper is to explore the impact that cost overruns and time delays exert on large public construction projects to clarify how past and current research regard factors causing cost overruns and time delays in large public construction projects. Design/methodology/approach This paper, which is based on an analysis of a literature selection consisting of 40 journal articles, investigates and ranks the occurrence of and the explanations for cost overruns and time delays in large public construction projects. The study makes use of a kiviat diagram/radar chart in order to visualize multivariate data. Findings Aggregated rankings of important causes of cost overruns and time delays are reported. These show a strong emphasis on the management aspect as a primary cause of cost overruns and delays. Additionally, there seems to be a trend toward deemphasizing the role of financial considerations in explaining cost overruns and delays. It is argued that there needs to be a more rigorous assessment of the impact that each factor has on cost increases and delays based on factual observed data as opposed to retrospective accounts from questionnaire respondents. Research limitations/implications Only public construction projects have been considered. The results will not be directly applicable to privately funded construction projects and/or projects of a smaller size. Originality/value The use of trend data, as illustrated in a kiviat diagram, showing how different ranking factors causing cost overruns and time delays has changed in importance over time.

PurposeThe paper seeks to suggest methods that will enable innovative and effective communication and collaboration between clients and construction project management professionals.Design/methodology/approachThe methodology involves workshops with construction clients documented in working documents circulated to participants.FindingsWorkshops revealed trends that urge a re‐evaluation of the briefing process. The need for better briefing with the focus on end‐users is increasing. The findings also pointed to difficulties for construction projects to deliver what the user‐clients need. There was considered to be a lack of systems and methods to keep track of user client demands sufficiently and in a satisfactory way. Goals need to be iterated and validated on a regular and coherent basis throughout projects. An increased interest for process‐oriented and strategic briefing was indicated.Research limitations/implicationsFurther studies are required to develop a client/user driven construction process that is more than just new statements. Research needs to address not only issues in the business as such, but also what requirements should be put on the education and training of stakeholders who are active in the construction sector.Practical implicationsThe paper presents a challenge to the traditional role of several actors; there is a need to communicate core business needs to construction prerequisites in a reciprocal way. There is a need of choosing logic – however, this does not diminish the need for methodologies for capturing, processing and verifying requirements in the process of provision of facilities to a user.Originality/valueThe paper proposes the idea that different logics govern actions by construction industry stakeholders, an issue the construction sector needs to address.

PurposeThe aim of this paper is to increase the understanding of clients' attitudes to project success and to measuring performance. Four questions are discussed: what are the success factors, what are the success criteria, how to achieve success and what are the characteristics of systems for measuring project performance? The findings will support the development of systems for measuring performance in construction projects.Design/methodology/approachThe paper focuses on professional clients and their organizations within the field of Swedish construction. It is based on semi‐structured interviews with 23 experienced individuals within professional client organisations.FindingsThe most important success factors have been identified as the user's participation, commitment to the project, high standard of quality consideration among the construction workforce and team working. The most important characteristics for systems for measuring performance are simplicity and credible results.Practical implicationsConstruction clients are often viewed in the literature as having similar views on project success. However, their views differ depending on their businesses, i.e. if they build to accommodate its own organisation, build to own and let or build to sell for maximised profit. This must be considered when developing systems for measuring performance.Originality/valueThe paper presents Swedish professional clients' views on project success. The findings are useful when designing and developing systems for measuring performance in construction projects.

Healthcare facilities are facing huge challenges due to the outbreak of COVID-19. Around the world, national healthcare contingency plans have struggled to cope with the population health impact of COVID-19, with healthcare facilities and critical care systems buckling under the extraordinary pressures. COVID-19 has starkly highlighted the lack of reliable operational tools for assessing the level sof flexibility of a hospital building to support strategic and agile decision making. The aim of this study was to modify, improve and test an existing assessment tool for evaluating hospital facilities flexibility and resilience. We followed a five-step process for collecting data by (i) doing a literature review about flexibility principles and strategies, (ii) reviewing healthcare design guidelines, (iii) examining international healthcare facilities case studies, (iv) conducting a critical review and optimization of the existing tool, and (v) assessing the usability of the evaluation tool. The new version of the OFAT framework (Optimized Flexibility Assessment Tool) is composed of nine evaluation parameters and subdivided into measurable variables with scores ranging from 0 to 10. The pilot testing of case studies enabled the assessment and verification the OFAT validity and reliability in support of decision makers in addressing flexibility of hospital design and/or operations. Healthcare buildings need to be designed and built based on principles of flexibility to accommodate current healthcare operations, adapting to time-sensitive physical transformations and responding to contemporary and future public health emergencies.