Owner-requested Changes in the Design and Construction of Government Healthcare Facilities

In the inherently dynamic industry of healthcare design and construction, organizations are continually working to achieve balance between customer demands and the need to manage cost, schedule, and quality. Owner-requested changes throughout the design and construction process can lead to budget and schedule overruns as well as increased uncertainty for the project delivery team. Effective strategies for the management of these changes can be used by project teams to reduce the number of changes during construction. The aim of this paper is to develop a multi-pronged approach to the management of owner-requested changes through the analysis of a relevant case study project. A review of existing literature showed that extensive research has been done on the cause and effect of project change, however, none focused solely on owner-requested changes. To expand the current knowledge base, a case study method was used to collect information on challenges and potential strategies for the management of these changes. A quantitative analysis examined project data in order to understand how owner-requested changes impacted and shaped the construction of the case study project. An in-depth qualitative analysis built on the project data through semi-structured interviews with project stakeholders. The themes identified in the data formed the framework for the compilation of lessons learned and best practices offered by the interview participants. It is hoped that these strategies will be utilized by future project teams to effectively prevent or mitigate owner-requested changes. The results of the analysis underscore the significant challenges involved in the design and construction of healthcare facility projects. Extended timeframes for project delivery, constant changes in technology, stringent regulations, and the sheer complexity of the building typology make healthcare projects among the most complex and logistically challenging projects built today.