Making Sense of Hospital Project MisPerformance: Over Budget, Late, Time and Time Again—Why? And What Can Be Done About It?

Hospital projects worldwide often experience misperformance, showing a tendency to exceed their estimated cost, miss their deadline, suffer quality problems, and yield benefit shortfalls. Considering this ubiquitous problem, this paper aims to make sense of this phenomenon by addressing the following research question: How can we make sense of hospital project misperformance, and what can be done to mitigate its occurrence? We use an illustrative case study approach and the analytical lens of sense-making to examine the misperformance of three mega-hospital projects. Our research reveals issues such as scope changes, an inability to adapt and respond to risk and uncertainty, ineffectual project management and governance, and optimism bias, which combine to impact project performance adversely. We suggest that the two prominent theoretical perspectives dominating the literature in this field fall short of adequately explaining hospital project misperformance. We provide suggestions for improving the procurement process of hospitals and submit there is a need to develop a robust and balanced theory of project misperformance

Large-Scale Transport Infrastructure Project Performance: Generating a Narrative of Context and Meaning

In this article, we go beyond the proverbial appreciation that context matters and provide a deep exploration of how and why it can help make sense of cost deviations in large-scale transport projects (>$500 million). Using abductive inference in combination with a multiple case study approach, the criteria of planning, funding, scope, contract, challenges/issues, and benefits are used to understand and interpret the context and meaning of project cost performance. By comparing two light rail transit systems and conducting an in-depth examination of a road project, this article examines the differences between procurement approaches and worldviews and how they can introduce bias into a project's cost performance outlook. The contributions of this research are threefold as it provides an avenue for a new line of inquiry to help better understand causal inferences, thus contributing to the development of a plausible theory of project cost performance; highlights the ambiguity associated with cost performance assessment and calls for the use of standardized definitions and terminologies so that evidence-based decision surrounding risk and uncertainty can be enacted; and suggests that by engaging in a collaborative benchmarking process of project completion data, the context and meaning of a project's performance can be documented

Risk and Uncertainty in the Cost Contingency of Transport Projects: Accommodating Bias or Heuristics, or Both?

Transport projects are regularly subjected to cost misperformance. The contingency set aside to cover any increases in cost due to risk and uncertainty issues is often insufficient. We review approaches that have been used to estimate a cost contingency. We show that some approaches such as reference class forecasting, which underpins the planning fallacy theory, take a biased view to formulate a contingency. Indeed, there is a perception that the risks and uncertainties that form the parts of a cost contingency cannot be accurately assessed using heuristics. The absence of an overarching theory to support the use of heuristics has resulted in them often being downplayed in a project's investment decision-making process. This article fills this void and provides the theoretical backdrop to support the use of heuristics to formulate a cost contingency. We make a clarion call to reconcile the duality of the bias and heuristic approaches, propose a balanced framework for developing a cost contingency, and suggest the use of uplifts to derisk cost estimates is redundant. We hope our advocacy for a balanced approach will stimulate debate and question the legitimacy of uplifts to solely debias cost estimates

The ‘context’ of transport project cost performance: Insights from contract award to final construction costs

Despite the plethora of studies examining the cost performance of transport projects, we still do not fully understand why they exceed their agreed price for construction. A lack of an in-depth exploration of context has contributed to this lack of understanding. In this paper, we seek to provide a context as to why the construction costs of transport projects experience increases from their contract award. We adopt sense-making approach, which is qualitative in nature, to examine the performance and financial reviews for eight transport projects constructed by an Australian contractor. The reviews are checkpoints undertaken during the construction of projects to monitor actual costs and forecasted profits for the contractor. The reviews are performed at the 50% and 75% milestones of a project's forecasted schedule by a team independent from the contractor's organization. We look into context states of projects such as their programme, quality, safety, design, and management. We use a context breakdown structure to uncover the ‘contexts within contexts’ that significantly contribute increases to construction costs. We reveal that the mean forecasted contractor margin was almost 9%, which reinforces the belief that there is a lack of competition in the marketplace. Overall, the hierarchy of contexts within contexts we unravel provides further understanding as to why transport projects experience increases in their construction costs. Considering the nature of the recurring contexts that we identify, we recommend that governments re-calibrate their approaches to procuring their transport projects. We suggest that they embrace negotiated contracts, alliance contracting, leadership and resourcing strategy, and work toward establishing a generative culture in the projects they procure

Error aversion or management? Exploring the impact of culture at the sharp-end of production in a mega-project

The research we present in this paper addresses the following question: What type of error culture does the rank-and-file workforce experience during construction, and does it help mitigate rework? We undertake an exploratory case study of an Alliance, which forms part of a transport mega-project. An error culture questionnaire is administered to the Alliance's subcontractors' workforce across four projects. We find that an error management culture positively correlates with reductions in rework and holds a divergent relationship with an error aversion culture. We further reveal a negative association between an error aversion culture and the ability to reduce rework. Consequently, we question the contemporary wisdom that assumes that error prevention should be combined with error management to create an adaptive culture, aiming to minimise the negative and maximise positive error consequences. We finally discuss the study's limitations and implications for future research examining error culture in construction projects

Identifikasi Perubahan Kualitas Pasteurisasi Susu Sapi Segar Menggunakan Teknologi Pulsed Electric Field (PEF)

Di Indonesia, proses pasteurisasi susu segar yang umum digunakan adalah pasteurisasi termal, yaitu proses pengolahan susu dengan menggunakan pemanasan antara 60°C-100°C. Selama periode pengolahan pangan termal, energi dalam jumlah besar ditransferkan ke makanan. Energi ini dapat menyebabkan reaksi yang tidak diinginkan, seperti adanya kehilangan vitamin,nutrisi esensial perubahan warna, rasa dm bau. Salah satu pilihan teknologi pengawetan susu segar yang ditawarkan adalah pengolahan pangan dengan metoda non termal yang menggunakan kejutan listrik tegangan tinggi (Pulse Electric Field atau PEF), yaitu sistem pengolahan bahan pangan yang didasarkan pada aplikasi denyut pendek pada tegangan tinggi (antara 20 — 80 kV/cm) ke bahan makanan yang ditempatkan diantara dua elektroda pada suhu kamar atau di bawahnya selama beberapa detik. Metode ini sangat efektif karena dapat menginaktifkan mikroorganisme sampai 99% tanpa merubah warna, rasa dan bau dan kandungan gizi dalam waktu yang sangat singkat. Tujuan dari penelitian ini adalah merancang bangun unit pasteurisasi susu berbasis teknologi pulse electric field (PEP) dengan penggunaan variasi tegangan, jumlah pulsa perdetik dan waktu kejutan serta menganalisa perubahan nilai mutu fisik susu segar dengan parameter kadar air, viskositas, warna, berat jenis, titik didih dan titik beku, perubahan mutu kimiawi dengan parameter timbal keasaman, pH dan total padatan terlarut, perubahan nilai gizi dengan parameter protein, lemak, karbohidrat, abu dan vitamin C dan total mikroba, total koliform, dan total staphylococcus aurues. Berdasarkan hasil pengujian mikrokontroler, rangkaian mikrokontroler dan perangkat lunaknya telah bekerja dengan baik Mikrokontroler telah dapat menghasilkan sinyal pulsa dengan dutycycle 0.5 dengan frekuensi 20KHz. Duty cycle 0,5 menunjukkan waktu pulsa on (Ton) sama dengan pulsa off (Toff). Pada waktu pulsa on tegangan keluaran mikrokontroler sebesar 4,2 V, sedangkan frekuensi kerja mikrokontroler disesuaikan dengan kinerja HV trafo yang hanya dapat bekerja pada frekuensi 22KHz. Lamanya pulsa yang diberikan tergantung pengaturan waktu yang disetting melalui keypad. Berdasarkan pengujian mikrokontroler telah dapat mengatur lamanya waktu pengolahan yang diseting melalui keypad. Berdasarkan pengujian rangkaian driver untuk HV trafo, rangkaian ini juga telah bekerja dengan baik. Rangkaian driver ini terdiri dari dua bagian yaitu rangkaian pemisah antara HV trafo dengan mikrokontroler yang terdiri dari transistor daya C2211, trafo OT dan transistor daya C5802 dan rangkaian masukan HV trafo yang berfungsi untuk pengaturan besar tegangan tinggi yang dihasilkan HV trafo. Pengaturan tegangan tinggi yang dihasilkan dapat dilakukan pada saklar pemilih. Pada penelitian ini tegangan tinggi dapat diatur mulai 20 kV, 40 kV, 60 kV dan 80 kV. Bentuk gelombang yang dihasilkan rangkaian pembangkit pulsa tegangan tinggi berbentuk pulsa kotak. Efisiensi maksimum pulsa kotak tergantung pada rise time pulsa yang pendek. Rangkaian pembangkit pulsa rimim tinggi pada penelitian ini menghasilkan bentuk gelombang pulsa kotak dengan frekuensi 22KHz. Sehingga periode untuk setiap pulsa yang dihasilkan sebesar 0,45 ps. Jumlah pulsa yang dihasilkan ra.ngkaian pembangkit pulsa ini dalam satu detik sebesar 1/ 0,45 ps = 22000 pulsa. Rangkaian pembangkit pulsa yang dihasilkan dapat mengatur waktu pengolahan. Dengan waktu pengolahan selama 10 detik, maka jumlah pulsa yang diberikan ke chamber sebesar 220.000 pulsa. Semakin lama waktu pengolahan maka jumlah pulsa yang dikirim ke chamber juga akan semakin besar. Hasil analisa menunjukkan bahwa sifat fisik susu hasil pasteurisasi tidak berubah secara signifikan yang meliputi berat jenis, viskositas, kadar air, titik didih, warna merah dam kuning. Berat jenis memiliki kisaran 1,0198 - 1.026 gr/cm. Viskositas berkisar antara 0.9444— 0.9581 cp. kadar air berkisar antara 89,48 — 90.2%. Titik didih, dan titik beku berkisar antara 94 —95% dan 4 hingga -5°C. Angka kcjernihan antara 67,7 — 69.2, angka merah 9.8 — 12.8 dan angka kuning 10.4 —15.90. Hasil analisa kimia menunjukkan bahwa susu hasil pasteurisasi tidak berubah secara signifikan yang meliputi pH, total asam dan total padatan terlarut pH berkisar antara 6.57 — 6.73, total asam 0.04% dan total padatan terlarut 11.25%. Kandungan gizi susu hasil pasteurisasi yang diamati tidak berubah secara signifikan yang meliputi karbohidrat, protein, lemak Abu dan vitamin C. Karbohidrat berkisar antara 2.14 — 3.97%, protein berkisar 2.49 — 2.81%, lemak berkisar antara 3- 4.29% abu berkisar antara 0.54 - 0.85% dan Vitamin C berkisar antara 0.41 - 0.44%. Teknologi pulsed electric field mampu menurunkan jumlah total mikroba, total koliform, dan total staphylococcus aureus. Semakin besar tegangan dan semakin panjang waktu perlakuan, maka mikroba yang terbunuh semakin banyak. Perlakuan terbaik diperoleh pada tegangan 100 kV selama 30 detik, dengan total mikroba akhir sebesar 9,7x103 cfu/ml atau (dari mikroba awal sebesar 2.9x105 cfu/ml) dan keefektifan pembunuhan mikroba sebesar 96.65%. Total koliform akhir sebesar 300 cfu/ml (dari kaliform awal sebesar 1.3x103 cfu/ml)dan tingkat keefektifan pembunuhan koliform sebesar 76.92%. Total staphylococcus crurcus akhir sebesar 160 fu/ml (dari jumlah awal sebesar 1.6x103 cfu/ml) dan tingkat keefektifan pembunuhan staphylococcus aureus sebesar 90%

Error culture and its impact on rework: An exploration of norms and practices in a transport mega-project

Rework has been and continues to be a problem during the construction of transport mega-projects. This article examines the error culture of an alliance that forms part of a transport mega-project to determine its effectiveness in mitigating rework. Our article reveals that an error management culture positively correlates with reducing rework and holds a divergent relationship with an error aversion culture. We further show a negative association between an error aversion culture and the ability to reduce rework. It is suggested that more can be done to reduce errors and rework despite the prevalence of a strong error management culture in practice. We thus call for an explicit focus on reducing negative error consequences and developing strategies to handle errors. The article argues that providing a psychologically safe work environment, understanding and focusing on what goes right, and coaching to ensure that learning is transferred from an individual to an organizational level can reduce rework. Our study is the first attempt to examine the homogeneity of error culture (i.e., how errors and their consequences are dealt with) in an alliance mega-project setting. In addition, it provides a new line of exploration to address the issue of rework

A procurement policy-making pathway to future-proof large-scale transport infrastructure assets

Governments worldwide have made a significant financial commitment to combat increasing traffic congestion and ageing transport networks over the next decade. However, large-scale transport projects are often late, over-budget, and below quality, making it difficult to future-proof assets and accommodate unanticipated changes. Evidence indicates that the traditional procurement model for large-scale projects used by Australian State Governments, for example, fails to deliver expected benefits. Markedly, a focused policy-making pathway is absent, especially for future-proofing these complex projects. Hence, the need to move away from a prevailing ‘understand, reduce, respond’ to a more adequate ‘understand, embrace, adapt’ attitude towards complexity and uncertainty in project procurement. The enabling functions of asset management, digitization, delivery, and finance might help. However, little is known about how they can coalesce to form a policy-making pathway to provide governments value for money outcomes and ensure assets are future-proofed. In this paper, we fill this void by reviewing the normative literature and proposing a conceptual approach. The issues we examine are of the utmost interest to governments worldwide as they grapple with designing, constructing, operating and maintaining transport assets that are both resilient to unexpected events and adaptable to changing needs, uses or capacities including climate change

A procurement policy-making pathway to future-proof large-scale transport infrastructure assets

Governments worldwide have made a significant financial commitment to combat increasing traffic congestion and ageing transport networks over the next decade. However, large-scale transport projects are often late, over-budget, and below quality, making it difficult to future-proof assets and accommodate unanticipated changes. Evidence indicates that the traditional procurement model for large-scale projects used by Australian State Governments, for example, fails to deliver expected benefits. Markedly, a focused policy-making pathway is absent, especially for future-proofing these complex projects. Hence, the need to move away from a prevailing ‘understand, reduce, respond’ to a more adequate ‘understand, embrace, adapt’ attitude towards complexity and uncertainty in project procurement. The enabling functions of asset management, digitization, delivery, and finance might help. However, little is known about how they can coalesce to form a policy-making pathway to provide governments value for money outcomes and ensure assets are future-proofed. In this paper, we fill this void by reviewing the normative literature and proposing a conceptual approach. The issues we examine are of the utmost interest to governments worldwide as they grapple with designing, constructing, operating and maintaining transport assets that are both resilient to unexpected events and adaptable to changing needs, uses or capacities including climate change

From Quality-I to Quality-II: cultivating an error culture to support lean thinking and rework mitigation in infrastructure projects

While lean thinking may help tackle waste, rework remains an ongoing problem during the construction of infrastructure projects. Often too much emphasis is placed on applying lean tools rather than harnessing the human factor and establishing a culture to mitigate rework. Thus, this paper proposes the need for construction organisations to transition from the prevailing error prevention culture (i.e. Quality-I) that pervades practice to one based on error management (i.e. Quality-II) if rework is to be contained and reduced. Accordingly, this paper asks: What type of error culture is required to manage errors that result in rework and to support lean thinking during the construction of infrastructure projects? We draw on the case of a program alliance of 129 water infrastructure projects and make sense of how it enacted, in addition to lean thinking, a change initiative to transition from error prevention to an error management culture to address its rework problem. We observed that leadership, psychological safety and coaching were pivotal for cultivating a culture where there was an acceptance that ‘errors happen’ and effort was directed at mitigating their adverse consequences. The contributions of this paper are twofold as we provide: (1) a new theoretical underpinning to mitigate rework and support the use of lean thinking during the construction of infrastructure projects grounded in Quality-II; and (2) practical suggestions, based on actual experiences, which can be readily employed to monitor and anticipate rework at the coalface of construction