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Planning Stages in Project Management: Development of the
100 - Bedded Hospital Construction Project in Hyderabad,
This dissertation involving interviews with the 100 bedded hospital construction
assesses the importance of Project Management in Hyderabad, India. Chapter 1
Introduces a general back ground of the construction literature by locality in building
program. Chapter 2 Review the literature is related to (1) a brief section on the need for
100 beds hospital, (2) planning, (3) designing, (4) contracting, (5) construction. Chapter
3 Describes the research design and methodology used and the interview format.
Chapter 4 Presents the results of data interpretation of the project under taken. Chapter 5
Presents the recommendations. Chapter 6 The final chapter discusses conclusions and
offers suggestions for further research.
Appendices present 1. The Interview Plan
2. The Interview questionnaire
3. Construction Map
Planning Stages in Project Management: Development of the
100 - Bedded Hospital Construction Project in Hyderabad,
Submitted to the Faculty of
University of East London
In partial fulfillments of the requirement for the degree of
Masters in Project Management
Chembolu Sridhar VV
Dissertation Director: Dr. Brendan D’Cruz
Chembolu Sridhar V V
University of East London
University of East London – The Business School
CERTIFICATE FOR APPROVING THE DISSERTATION
We hereby approve the Dissertation
Chembolu Sridhar V V
Candidate for the Degree:
Masters in Project Management
University Register No: U0634537
Module Code: SMM 215
Module Name: Applied Dissertation / Project
Dissertation Director: Dr. Brendan D’Cruz
First of all, I would like to thank my supervisor Dr Brendan De’Cruz for his
continuous guidance and enthusiastic support of my work.
I am also indebted to my advisors and my family who provided me with many
valuable guidance and information for my research and for my life. All of you have
given me great ideas and motivation to carry out the research and have made my work
possible. I also would like to thank my previous organizations for giving me the
possibility conducting interviews.
During my work as a Masters education as student I have met many interesting
and friendly individuals that contributed greatly to the quality of my work and that
made it a very enjoyable experience. I realise that mentioning a few will leave out many
Others, but I especially would like to thank Mahesh, Padma, for being such great and
I am grateful to my family and friends in India for their support and for
encouraging me to do the best.
Siri, Rohini, Babjee, Rama Krishna, Raj Kumar, Celine, Arun, Vardhan, Ravi
Kumar, thank you for always being there for me.
Finally, My parents
(Smt. Krishna Veni Chembolu and Shri Narasimheswara Rao Chembolu) are
wonderful, thank you for always supporting me and for all your sacrifices during my
studies. You are truly the most important part of my life!
6th, May 2008
Chembolu Sridhar VV
TITLE SHEET II
CERTIFICATION SHEET III
TABLE OF CONTENTS IV
CHAPTER I 1
1.0 INTRODUCTION 1
1.1 What is Project Management of a construction project? 2
1.2 Indian Construction Industry 3
1.3 Construction of a Hospital Building 5
1.4 Statement of the problem 5
1.5 Central Issue 7
CHAPTER II 8
2.0 REVIEW OF THE LITERATURE 8
2.1 Need for 100 Bedded Hospital 8
2.2.0 Planning 8
2.2.1 Determining the Safety Planning Process 10
2.3.0 Designing 12
2.3.1 Selecting an Architect 12
2.3.2 Selecting the Hospital Specification Writer 15
2.3.3 Developing Health care Specifications 16
2.3.4 Construction Options 18
2.3.5 Schematic Design Phase 19
2.3.6 Design Development Phase 20
2.3.7 Construction Documents 22
2.4.0 Contracting 23
2.4.1 Advertising and Bidding the project 23
2.4.2 Receiving Bids 24
2.4.3 Tabulating Bids 24
2.4.4 Analyzing Bids 24
2.4.5 Awarding and Execution of Construction Contracts 25
2.5.0 Construction 26
2.5.1 Ground Breaking 26
2.5.2 Construction Administration 26
2.5.3 Change Orders 28
2.5.4 Payments 28
2.5.5 Building Activation 28
2.5.6 Punch list 29
3.0 METHODOLOGY 30
3. 1 Statement of the Problem 30
3.2 Purpose of the Study 31
3.3 Hypothesis 31
3.4 Aims and Objectives of the Study 32
3.5 Research methodology 32
3.6 Sample composition 33
3.7 Area of the present study 33
3.8 Importance of the present study. 34
CHAPTER IV 35
4. 0 DATA INTERPRETATION AND ANALYSIS 35
4.1 STAGE-I 35
4.2 STAGE-II 40
4.3 STAGE-III 42
4.4 STAGE-IV 43
4.5 STAGE-V 46
CHAPTER V 48
5.0 KEY RECOMMENDATIONS 48
5.1 Architectural 48
5.2 Planning 48
5.3 Cost 48
5.4 Construction 49
5.5 Coordination 49
5.6 General 49
CHAPTER VI 51
6. 0 CONCLUSIONS 51
APPENDIX 1 The Interview Plan 57
APPENDIX 2 The General Questionnaire 59
APPENDIX 3 Letter for the Interview 62
APPENDIX 4 Confirming Letter 63
APPENDIX 5 Construction map 64
APHMHDIC - Andhra Pradesh Health and Medical Housing and
Infrastructure Development Corporation.
MCH - Greater Municipal Corporation of Hyderabad
BIM - Building Information Management
NIDC - National Industrial Development Corporation
The beauty of a civilization is seen in its construction and architecture. Behind the
sweeping domes to high rises that disappear in the clouds we see the hands of genius.
Some of the spectacular structures like the Australian museum have become symbolic
of that country and its culture. The developments that have taken place in the present
days allow architects and engineers to continuously push forward, combining classy
designs that can stand both the test of time and memorability. Building construction and
its management has become a very important aspect in today’s globalised world. It is
the process of adding structure to real property. Infrastructure is basically the
combination of architecture, engineering and construction to develop into a purposeful
Construction is defined ‘‘the use of multi-disciplinary performance models of design-
construction projects, including the product (i.e. facilities), organization of the
design-construction-operation team, and work processes, to support explicit and
public business objectives. ’’ (Martin Fischer, 2001). Likewise a project is defined to
have a definite start date and a completion date. — This is undertaken to create a
matchless construction or design, this also brings about valuable change or added value.
A project is a carefully defined set of activities that use resources like the people,
budget, material, communication and motivation to achieve the project goals and
objectives for the successful execution of the project. Planning is essential for the
effective project management.
Multitasking is the real feat of large-scale project in the field of construction. The
project manages is the key person to manage the job supervised by project architect,
construction engineer, design engineer and the construction manager. Construction
Management refers either to the ‘‘study and practice of the managerial and
technological aspects of the construction industry (including construction,
construction science, construction management, and construction technology), or to
a business model where one party to a construction contract serves as a construction
consultant, providing both design and construction advice. ’’ (Wikipedia)
Construction project managers are involved in both public and private construction
projects. These managers study the technological aspects of the construction industry.
The various components like time, cost, people, material, conflicts are part of the
project. The project management is iterative process of coordinating and managing the
entire project to the completion stage. This involves the selection of the required people
for the project like the architects, construction project managers, civil engineers and the
contractors. Architects are involved in the design of the project and the construction
project managers in the execution of the construction considers various environmental
factors like the job, costing , safety, logistics of the material , construction delay caused
due to public inconvenience and preparing tender documents.
1.1 What is Project Management of a construction project?
The process of understanding the design and construction requires knowledge of
modern management and technical skills. Time bound need to have a set of specific
objectives and constraints. The process would differ according to the institutional
arrangements. The management is common to any project in other areas of other
speciality and technology domains.
Design and construction processes are the two important factors with knowledge of
modern management are required for managing the construction of projects.
Construction projects have a specific set of objectives and constraints such as a required
time frame for completion of the project. The domains with technology in the different
sectors such as aerospace, energy developments and pharmaceutical have in common
management practice. The art of project management is not the same general
management. The area of expertise is famous for mission-oriented nature for the quicker
and smooth delivery of the project. At last, a project management team is terminated
after the mission is accomplished. According to the Project Management Institute, the
discipline of project management can be defined as follows:
‘‘Project management is the art of directing and coordinating human
and material resources throughout the life of a project by using
modern management techniques to achieve predetermined objectives
of scope, cost, time, quality and participation satisfaction.’’
In particular, a set of controlled operations subject to constraints of resources. The
potential clashes and differences are scope, quality, time and the financial resources for
any project. For any alternatives in a project, all the conflicts should be resolved prior to
construction. The most important functions of project management for construction
include the following:
1. ‘‘ Specification of project objectives and plans including delineation of scope,
budgeting, scheduling, setting performance requirements, and selecting
2. Maximization of efficient resource utilization through procurement of labour,
materials and equipment according to the prescribed schedule and plan.
3. Implementation of various operations through proper coordination and
control of planning, design, estimating, contracting and construction in the
4. Development of effective communications and mechanisms for resolving
conflicts among the various participants. ’’ (http://www.andrew.cmu.edu)
1.2 INDIAN CONSTRUCTION INDUSTRY
The construction industry is the second largest industry in India after agriculture. It
accounts for about 11% of India’s GDP. In the Indian economy building construction is
the major driver as an activity. It is comprised of residential and non-residential
building. Covering as it does such a wide spectrum, construction becomes the basic
input for socio-economic development. (http://www.planningcommission.nic.in)
The development of construction industry in India is similar to any other countries
founded by Government and the industry was gradually taken over by the enterprises.
The Indian government laid foundation after the independence to make developments in
the sectors like the industrial, infrastructural in the architectural, construction and in the
engineering services. The development was high during the period 1950 to mid 60’s
playing an active role in the development of construction by the state owned enterprises
and supported by other government departments for the benefit of the country. Fifty
percent of the total capital outlay was allotted to the civil works in the construction
industry in the first five-year plan.
National Industrial Development Corporation (NIDC) was the first professional
consultancy company, was set up in the public sector in 1954 and at a later date in the
public sector by Indian Railways Construction Limited, Engineers India Limited and in
private sector Hindustan Construction Company and M N Dastur and Co.
The objective and motive behind international consultancy in construction was
to develop local design with the imported technology and skills set was encouraged by
the government. That was first issued by government in the late 1960’s.
The industry is extremely diverse, with employment in firms ranging from a few
people in family owned enterprises to thousands in major firms. The construction and
engineering industries have been among the most significant contributors to the growth
in the Indian economy in recent years through employment, export and import. These
sectors have undergone a massive transformation and have played a huge part in
transforming India into an advanced nation at the cutting-edge of technological,
engineering and manufacturing developments and change. With government investment
pouring in to improve India’s infrastructure, the construction industry is also performing
steadily despite a recent slow down according to (http://industry.gov.au).
In the past 50 years the Indian construction industry has accounted for around 40
percent of the development investment. The livelihood of about 16 percent depends on
the construction industry. Three crores of people are employed and assets worth over
20,000 crores of rupees were created in the Indian construction industry. Construction
in India contributes more than 5 per cent to the nation’s GDP and capital formation of
87 percent. Total capital expenditure of state and central govt. will be touching Rs
8,00,000 crores in 2011-12 from Rs. 1,43,587 crores(1999- 2000). (www.
1.3 CONSTRUCTION OF A HOSPITAL BUILDING
Construction involves buildings meant for different purposes such as residential
buildings, offices etc. One such purpose built construction is construction of a hospital.
Hospitals are among the largest and most complex of all modern institutions. Unlike
other organizations, which may be built in various ways, hospital building has lesser
choices. The hospitals have complexity in design and of the functional relationships
when compared to the other facilities. The category of zoning creates plans for the
emerging issues to the requirements and to the latest trends for designing, planning,
constructing and along with complexity in building the facility.
1.4 STATEMENT OF THE PROBLEM
The projects in construction are disreputable for headaches for all parties involved in the
Rarely the projects come in 'under budget' or 'on schedule' due to some serious
thinking behind the scenario. Some other exception challenges come into picture when
the construction project relates to a hospital. The issues like budget, financial
constraints, the process of construction and the public view scrutinized by the board
members and the political aspects of the hospital are quite severe. The hospitals have to
face challenges which comply with regulations, standards and the myriad of statues.
Unfortunately, the people following the trade like architects, construction managers and
contractors are unfamiliar with legal requirements. The failure to comply could result in
failure and incurring hefty fines. Even worse, a hospital’s failure to meet the terms in
construction project may halt indefinitely or in with the substantial change orders issued
to bring the project ‘up to code’.(Hospital Construction, 2004)
The objective of this study is to create a reliable technique for categorize
adequate project management stages for construction project of a hospital in the
construction industry. The construction projects have both a good phase and bad phase
due to a number of problems and the situations. The significant part of the project is that
the projects are getting into a bad shape due to the pressure and with out proper project
management tools being implemented at the right time. Indian project in the
construction are usually late, over budget and poor workmanship during the test of
quality standards. Conflicts in the projects increase resulting in litigation and
negotiation with no stability during the course of the project. Due to no proper control
over the project the projects are delayed and these issues props up in the media like the
speed of light. The Project management professionals are required to master the latest
tools and techniques in the construction industry. The hypothesis of this learning is that
the construction industry could advance its performance on all of the grounds talk about
to the specifics of the project, if project management systems are created with proper
project management which deals with cost, function, time, quality and conflict. If the
construction industry does not improve, then it will be unsuccessful to take its place in
the Indian market as a most important force in the coming years. Latest methods are
essential which will allow the project team members, to identify objectives, and to
choose priorities for control management and proper feedback. To accomplish this hard
task, it is wished-for to establish a technique for modeling the relationships between
project environments, control management, objectives and feedback in the construction
project through out the life cycle of the project. The purpose is to confine and advice to
clients of the construction industry, and their advice-giver, the project objectives are to
be set. The project members should involve in the priorities of the activities with the
help of the management procedures and the project management plan. The wide-
ranging construction environment responds to cost-effective, physical and cultural
issues. These projects are not a wit of the local consultants who are involved in design,
planning, project viability, physical, materialistic and yet social. All the local people
need to consider the various factors and also to have the basic understating of these
requirements for any construction projects. Nevertheless, working in different countries
and different regions of the country, the understanding of these above aspects become
the success factors of the project. There is a lot of chance for the failure for all the
project members on the board who don't understand these issues without indulging into
the project prior to proper planning.
1.5 CENTRAL ISSUE
In the construction industry it is quite evident that the way the academics and the
practitioners approach towards the management level of planning of the construction
towards the minutest details in any stage of the project. Project management is the
means to define the leader in the construction industry for the time, cost and quality.
These are well defined and accepted to define the project constraints. These are the
starting aspects in the project management of any project. According to the
characteristics of the project the crucial success of the project is a project management
plan. This research considers the fundamental concepts in the construction of a project
the outfit this viewpoint. Based on the concept, the planned and evaluation of a project
were examined during the project management stages. (Wikipedia.org)
2.0 REVIEW OF THE LITERATURE
This chapter examines the literature that addresses the present study on 100
Bedded hospital project planning and construction addresses the following areas:
(1) A brief section on the need for 100 beds hospital, (2) planning, (3) designing, (4)
contracting and (5) construction.
2.1 NEED FOR 100 BEDDED HOSPITAL
The Infrastructure report India reported that construction works reached an all
-time high over the past five years. Strong policies have been proposed and introduced
by the state of Andhra Pradesh, India. To promote the growth in basic health care
facilities projects and positively change the living conditions through construction of
new hospitals. Recent initiatives include permission for 100% foreign-equity
participation in the construction industry.
The State Government of Andhra Pradesh has come up with an open
advertisement in the news papers for the construction of hospital for the local
community, (Cherukuri, 2002). This healthcare facilities project was proposed fifty
miles quite away from the city Hyderabad.
So, the need for construction of 100 Bedded hospital in the capital of Andhra
Pradesh was important.
Planning is the first and foremost thing for the construction of the project.
2.2.0 Planning Performing Community and 100 Bedded Hospital / Program
Analysis According to the Guide for APHMHDIC and GMCH (2006), developing a
community analysis is the first step in planning the 100 Beds Hospital. A systematic
community analysis includes a documentation of its history, and assessment of its
present status, and a projection of its future characteristics. In preparing the community
analysis, an effort should be made to determine what citizens expect from the State
Government of Andhra Pradesh and what health care facilities exist. The following are
examples of community characteristics that may require examination.
1. Population characteristics and density patterns.
2. Population changes due to in and out migration patterns and fluctuations in
the birth rate.
3. Changes in land usage (residential, commercial and industrial)
4. Major highway and street networks and their probable future development
5. Changes in locality boundaries.
6. Identity of the clients. What are their potentials needs?
The following steps were delineated for the planning process in construction. (Sunil,
‘‘1. Patient focused Hospital Architecture
2. Design Strategies to Assist Healing
The architecture plan should offer humanistic patient services and a
setting for efficient, technologically advanced facilities.
3. Physical Comfort such as Appropriate Lighting
5. Light/Color ’’ (http://www.indmedica.com)
Guidelines for the Hospital and healthcare facilities state that the minimum
guidelines set are the requirements of the program for the construction, space
requirements, for clinical and support areas of hospitals, nursing homes, facilities,
outpatient, and long-term care facilities. The guidelines to design a hospital project also
requires minimum engineering design and services designs criteria for plumbing,
medical gas, electrical, heating, ventilating, and air conditioning systems.
In addition to the information needed according to the hospital construction,
Nick (Bontis, 2007) identified the need for collection of two additional pieces of
information necessary to collect during the planning stage.
‘‘1. Administrative: What are the administration organization, practice and
procedures currently employed? What are the training requirements and
improvements to be carried over?
2. Financial: what is the financial condition? What funds are available to
support needed programs and the construction of hospital? ’’
(Henry Sanoff, 1999) added community goals to the list. He suggested that local
and regional planning agencies are excellent sources of information.
‘‘Identify the individuals or groups who should be involved in the participation
activity being planned. ’’
Higher officials in the similar fields are of much help for better solutions for the
Chan APC et al (2004) added to the list of the questionnaire:
‘‘Through a postal questionnaire survey geared towards project participants with
hands-on partnering experience, the opinions of various parties--clients, consultants,
and contractors were sought and evaluated in relation to partnering success factors.
2.2.1 Determining the Safety Planning Process
Reiling J (2006) wrote that:
‘‘The physical environment has a significant impact on health and safety;
however, hospitals have not been designed with the explicit goal of enhancing patient
safety through facility design. ’’ (http://www.newstjosephs.com)
Considerable time and effort must be spent on the design and planning process.
The health care leaders in the industry will make important contributions to the patient
safety and to the community.
‘‘A bad location of the site selection could be harmful to their care’’, stated
Cherukuri, (2004). Lack of adequate long range planning in the past has resulted in
many poorly located hospital construction projects because of pressured site selection.
Site selection of the future must consider all environmental issues. Cherukuri further
emphasized that the construction of hospital that does not meet the hospital philosophy
of the community or the demands of a changing environment leads to continuous
attention to physical needs. A well conceived hospital building program will strengthen
long- range financial planning and enable a community to attain the maximum financial
return from the community.
Hospital Planning and Design (Brown, 2004): Described planning as a team process
involving the board of hospital, hospital representatives, architects, engineers, special
consultants, construction managers, project managers and contractors.
Primary and secondary roles change throughout the project, allowing the
professional with greatest expertise to lead specific phases of the project.
The additions, deletions, and modifications should be an integral part of
determining the hospital facility needs .According to Cook (2001), ‘‘Strategic planning
is not just a ‘model’. That word can make a dynamic process nothing more than a
dull uninspiring scheme which can be superimposed on any existing organization or
circumstance. Strategic planning is an effective combination of both process and
discipline which, if faithfully adhered to, produces a plan characterized by originality,
vision and realism. The discipline includes the vital ingredients of the plan itself; the
process is the organizational dynamics through which the vital ingredients are
derived. Both the discipline and the process are aimed at total concentration of the
organisation’s resources on mutually predetermined measurable outcomes. ’’ (p
The essence of a strategic plan is the identification of specific desired results to
which all the effort and activity of the organization will be dedicated. And the success
of any plan is to determine only by the results it produced.
According to Cook (2001):
‘‘Strategic planning is not an edict, but a consensus plan derived through the
application of the basic principles of the participative management. Specifically,
(1) That those closet to the job know the job better than anyone else,
(2) That strategic information flows downward and operational information flows
(3) The decisions should be made at the lowest appropriate level. ’’ (p 94-95).
The components of the planning process are:
1. Selection of a facilitator
2. Setting the climate
3. Selection of the planning team
4. The actual planning session
5. Communication of the plan
6. Board Approval
7. Implementation (p 99-172)
The potential mass involvement of community members and hospital personnel
in the various stages of strategic planning is designed to create a community/hospital
based consensus on what is needed, how the additional revenue will be generated. The
plan has board approval and a built-in renewal process that, if properly implemented,
will guide a hospital through a construction and beyond.
Once the planning process is established by the board, planned variations were
noted .Space allotment and design, economical operation, and community support are
the important features for the hospital project. The team will need to develop questions
that can determine how input occurred that resulted in establishing the needs, wants, and
desires of the ‘‘users’’ of the hospitals.
Cherukuri (2002) presented concepts, features, and details contained in
exemplary hospital design.
1. The Designers at exemplary hospitals have typically developed a very strong
design of hospital plan with definite goals and objectives.
2. User friendly environment – creates a space where community people can
feel at home and welcome. The use of natural material and colors and
attention to the minutest details are all the hall marks of this type of hospital
3. Building serves as a source for learning about the structural mechanical and
electrical systems used in the construction of the building.
4. Space to provide a variety of hospital settings, thus providing a variety of
experiences. (p 33-34)
2.3.1 Selecting an Architect
The employment of an architect by a board of health care is one of the most
important responsibilities the board exercises in the development of hospital planning.
Steps to be followed in selecting an architect, according to the publication. Tamus
‘‘1. Facilities planning and Construction will develop a Request for Qualification
(RFQ) which will describe the project, requirements for a response to the
RFQ and evaluation criteria. The RFQ will be advertised on the Electronic
State Business Daily.
2. Each team response to the RFQ will be required to present its qualifications
and design approach for evaluation by the Selection Committee.
3. The Selection Committee members’ rankings are submitted to the Managing
Director of Facilities planning and Construction for tabulation and
determination of the Selection Committee’s recommended order of ranking.
4. The Managing Director then submits the ranked order along with an
evaluation of the top three to five respondents and a description of the
project to the Chancellor for approval and to the Board of Regents giving a
seven (7) day notice to the Board to give exception to the ranked order. ’’
According to A Project Planning Guide for Planning Healthcare Facility
owner (2007), the four processes for selecting an architect are design competition,
direct appointment, comparative selection, and competitive bidding. Design
competitions are time consuming, expensive, and rarely used for selecting an architect
for healthcare facilities. Direct appointment is the simplest of the process. It most often
occurs when prior knowledge of the architect’s work is known to the board and /or
superintendent through previous projects. Comparative selection involves choosing
from a group of candidates who have submitted to the owner information and materials
concerning their qualification.
A Project Planning Guide for Planning Healthcare Facility owners (2007)
states that, when an architect is invited to express interest and submit qualifications, he
should be given all pertinent information about the owner and the project.
The minimum information to be supplied to prospective architects includes:
1. Project brief and the times schedule for the proposed project.
2. Description of the space planning of the healthcare facility.
3. Description of the financial resources available for the project, fee structure,
and extent of services required.
Providing the architect with this information serves several functions and the
planning process, it permits the architects to judge the nature of the project and provides
the basic information on which architects may build data during the interview.
Architects invited to submit their qualifications for consideration should be asked to
provide the following information:
1. Name and address
2. Brief history of the firm, including date established type of work undertaken.
3. List of projects completed in the recent years showing type, size, cost,
location and dates completed.
4. A portfolio of works
5. Statement policy in handling of the projects, engineering services, and other
Competitive bidding is often used to obtain work and products in other phases of
the construction business. It is not an appropriate way to obtain professional services for
(You and Your Architect, 2005) published by the American Institutes of
Architects, pointed out that different projects require different combinations of
architectural services. Most projects require a set of basic services: preliminary
(schematic) design, design development, preparation of construction documents
(drawings, specifications, construction contract agreements) and administration of
arguments between the user and the contractor. Additional services that the owner may
wish to consider are:
‘‘1. Development of hospital facilities
3. Site utilization and utilities study
4. Planning and zoning specifications
5. Models and / or presentations
6. Landscaping and development. ’’ (p-20)
In addition to the services provided, the architect’s contract needs to include
adequate construction contract administration services (observing the construction work
for conformance to drawings and specifications, and produce samples, review the
results of construction tests and inspections, evaluating contractor’s requests for
payment, handling request for design changes during construction, and administrating
the initiation of the project to the closure of the project to the owner).
The contract needs to spell out how disputes between the owner and architect
will be settled (arbitration / mediation).
Also include a post – construction evaluation of the building six months to a
year after completion of the project is desirable.
Duff (1999 ) stated that the architect’s role should include:
1. Ability to function as part of a complex design team .
2. Acting as a advisory member on all planning committees, as well as the
preparation of the schematic design to the final drawings .
3. Responsibility also includes provisions of bid specifications, review the
proposal , contract award recommendations , supervision at the site and
administration of all contracts , approvals of all the contractors request and
payouts and finally provision of a limited warranty after the occupancy .
No design should begin without first being analyzed for its fitness into
construction master plan. (Cherukuri, 2006) was convinced with the design of the
building. Also provide guidelines to be followed during in the interview process.
Included in the statement: ‘‘don’t ask the prospective architect to make sketches,
predictions, or estimates. It’s premature at this point.’’
Duff (1999) also recommends employment of the architect in the early planning
stages of the construction project. The community needs and desires of the user are to
be considered to gain the best opportunity to provide the services.
2.3.2 Selecting the Hospital Specification Writer
The healthcare specification writer’s role in the overall picture is more advisory
than the role of either the architect or the user. Bogers (2008) described that this
position is the excellent position for converting the hospital concepts into hospitals
facilities on a proposed building for construction.
The consultant can be of assistance to healthcare officials (user) in a number of ways:
1. To advise on the selection of the architect and assist in selecting the site.
2. Review any hospital plans and make recommendations in light of
3. Review architectural plans and judge them in terms of their ability to satisfy
hospital needs. (p 109 -116)
According to A Project Planning Guide for Planning Healthcare Facility owners
(2007), often the planner serves the planning team as a catalyst and, at times, a referee.
Unlike many of the other planning professionals, the hospital planner path to the
profession is less clearly defined by an academic background. Their backgrounds are
diverse and include such fields as architecture, engineering or business administration.
Colleges and universities employ planners, but also ask them to teach or perform other
According to (Duff ,1999), the planner needs to be articulate in verbal and
written skills in order to communicate clearly to boards and committees the status of all
phases in the planning and decision process. The two primary areas of planner’s
1. Determining the general requirements for the healthcare.
2. Determining the time schedules for the project.
2.3.3 Developing Health care Specifications
According to Bogers (2008) ‘‘Healthcare specifications serve as the link between the
construction and healthcare facilities”. The purpose of healthcare specifications is to
describe clearly and concisely the various learning activities, their spatial requirements
and special features of the hospital activities to be housed in the hospital.
In A Project Planning Guide for Planning Healthcare Facility owners
(2007) the hospital specifications document is described as a vehicle of communication
between the hospital user and the architect. The planner identifies the basic needs; the
architect bases his facility design on this information.
The architect acts as a consultant to the professionals, board members, and
healthcare consultants. The following is a summary of elements to be covered in the
1. How many people are to be served in the area?
2. What types of healthcare facilities are to take place in the space?
3. Where should the space be located in relationship to the other facilities and
4. What are the electrical, plumbing, heating, ventilization, acoustical, and other
specialized needs of the spaces?
5. What other specialized considerations need to be met to house the planned
After answering these five questions , healthcare planners must look at the future
planning needs in the areas of flexibility and functionality, aesthetics, economy,confort,
health , and safety needs.
Guidelines for Design and Construction of Health care facilities owners
( 2006) the general rules for hospital administrators to follow when determining the size
of the site.
1. For hospitals, it is suggested that a minimum site of 25 acres to be provided .
2. After site has been selected , the board members must aquire site , if it is not
already owned .
Guidelines for Design and Construction of Health care facilities owners ( 2006) ,
there are five legally accepted methods .
1. Purchase from the owner – this is usually the most satisfactory method .
2. Accepting property as donation—acquisition of property by this method is
desirable only if there are no reversion clauses ,and the site has a clear and
3. Condemnation of private property (with purchase at fair market value)
4. Receipt of surplus government property , or
5. Lease of government owned property. (p - 112)
After the site has been selected , Guidelines for Design and Construction of Health
care facilities owners ( 2006) indicates that a comprehensive survey needs to be
conducted . The survey should provide at least the following information.:
1. Title of the survey , property location , certification and date .
2. Scale and compass orientation .
3. Names of abbuting property owners
4. Bench mark with assumed elevations
5. Names and locations of all existing road right-of-ways (p - 115)
Vince Galloro,(2005) recommended in addition to previouly mentioned
concepts, ‘the biggest difference in how the competition to build in the high-growth
areas will take shape’ for the construction of the hospitals .
2.3.4 Construction Options
The design selected and the funds available will influence the architect as to the
type of basic construction necessary to accomplish the goals set forth in the healthcare
May (2006) reports, ‘‘at various times, attempted to solve some of these
problems through the development of stock or model plans. Also mentions that It is
important to recognize that our research was not intended to create a comprehensive
catalog of all hospital construction in the CTS markets. ’’
Dailey (2004) states “In this environment, hospitals have both an obligation
and an opportunity to subject their facility planning and building programs to a
similar competitive analysis”. And also he describes that master plannig of the hospital
to take place in the early stages of construction . The features to be included at the at the
time of designing are design efficiency , operational impact , phasing sequence , project
budget and cost and finally the schedules to complete the project on time . Alternetivily
they shall to highlight the other best possible design options for construction with in the
time frame of the project and bugdet .
May (2006), describes that the construction projects should take care of the
importance of the planning phase and services for the safety of the patients.
Construction management contract (involved with construction supervision,
scheduling,coordination of inspections , tests , permits), improved performance
specifications of many subsystems components , required mandatory descriptions of
methods the contractors planned to use to interface with other subsystems ,
identification of pre-fabrication systems , stress reactions for the work done with the
flexible payment options and all the construction activities within the time frame are
discussed by the (Anneliese,2006).
Budgeting is quicker and easier for the purpose of estimating the construction of
the hospital project, provided the above discussed are properly documented and
organised for the proposed project as discussed by (Anneliese, 2006).
2.3.5 Schematic Design Phase
During the early stages of the schematic design phase , the architect explores
alternative concepts for the building , using the knowledge and understanding gained
from meeting with the board members and participating with the staff during the
development of the healthcare specifications , and from the survey information provided
for the site.
‘‘Asmussen believe that a healing architecture must be grounded in and
express 7 fundamental principles:
1. Unity of form and function.
4. Harmony with nature and site,
5. The living wall,
6. Color luminosity and color perspective, and
7. The dynamic equilibrium if spatial experiences. ’’ Were the basic seven
prinicples adopted while designing the schematic design phase as discussed
by Weber (1996).
These designs need to go back to the planning committees or to the stake
holders, administration and the board for their input. Involving the maximum number of
people in the decision making process will allow the project to get more funds and will
result in a better quality of the project. Also Terje Karlsen (2008) states, that ‘‘Trust is
built in a project-stakeholder relationship by improving communication skills,
behaving reliably, showing commitment, being sincere, benevolent and competent,
obtaining and acting with integrity, working towards reaching project milestones and
establishing common goals.”
The architect then is ready to prepare ‘preliminary estimates’ of construction and
site development costs.
When the schematic drawings are ready for approval , they will include a site
plan, simple exterior and interior elevations , or perhaps a perspective rendering and the
virtual models made with the help of softwares like Autocad , 3Dmax or Architectural
Desktop. These drawings will not include any engineering drawings, but preliminary
specifications in outline form should accompany and supplement the preliminary
drawings in sufficient detail to make clear to the board members the type of
construction, the interior and exterior finishes, the type of mechanical,electrical, and
plumbing provisions which will be implemented . The amount of funds available may
necessitate some considerable redesign of the approved design concept.
2.3.6 Design Development Phase
After approval of the schematic design by the members of the board , the two
to three months are very crucial for the entire project. The administrative team , staff of
the project, community citizens and the hospital specification writer need to review
every segment of architect’s progress, as the final design detail is being developed.
These above groups need to visualise the end product of the hospital and the ease of
Once the design development phase is completed, board approved and bids
accepted , any modification will require a change order. Change orders are costly and
their administration is time consuming .
Changing the construction techique and availability of new materials allows the
architect’s freedom to be imaginative and creative. Aesthetics, color, and lighting are
developed during the design development phase.
As far as the sterilisation conditions are concerned, The Engineer, (2007) has
tried to depict its effect on learning process at the time of planning for the better design
and healthy environment.
Aleda (1995) considered the following overall factors at the timing of Planning
(1) ‘‘Consideration of DRGs as products with a bill of resources structure that
simultaneously incorporates both capacity and materials resources,
(2)Implementation of a hospital-wide (versus a functional) planning and
control system. ’’
In addition to the above planning standards and other considerations are
determined by number of interrelated factors, including the following as discussed in
the Guideline for Design and construction of Health Care Facilities owners (2007).
1. The number, size, and orientations of windows
2. The quality and extent of insulation
3. The quality of ceiling
4. The climate
5. Building orientation
6. The efficiency of mechanical and electrical systems (p -125).
The architect/ engineer must consider all the above factors when designing a
hospital to provide thermal comfort with respect to their cost (both initial and life) ,
their effect on energy use , and their impact on the perceptions and behaviours of the
building users. This delicate task often involves balancing one need or priority against
another and selecting the most advantageous alternative.
HVAC, plumbing, electrical, fire security, building security, telephone cable,
computer cables and networking cables etc. Shall be designed and organized to fit into
the sandwich space (between ceiling tile and steel decking) in corridors. This eliminates
if any minor problems occurs.
‘‘As patients enter the medical center, they're greeted with a warm welcome.
Comfy lounge seating surrounds a large stone fireplace in the main lobby, which is
adorned with soft, earthy-colored materials and finishes. The warm colors and
stonework are carried throughout the building's main circulation corridor and into
the separate departments.’’ as imagined by the architect for the ultimate and final
delivery of the project after completion: Barista, (2007).
2.3.7 Construction Documents
The final component of the design development phase consists of complete and
detailed drawings, specifications, and cost estimates. Apart from the construction
documents all the risks involved at the time of planning and construction phase rewards
are equally shared and are agreed (Jeff, 2008). ‘‘Instead of relying on traditional
contracts and construction documents, the three firms and AutoDesk agreed to form
a four-way partnership that stipulated they work together as a team and share all
risks and rewards equally.’’ Jeff was also under the impression that during the design
phase and before the construction stage of the project, if all the contract documents are
correctly written by the specification writer the chances of risk involved towards the
construction of the hospital is to the optimum level. ‘‘This contract makes us true
partners where the incentives to profit are meeting benchmarks such as achieving
LEED certification and not putting in change orders or increasing the entire price of
the project. In this contract structure, the more accurately we share information, the
more risk we're mitigating.’’ As all the professionals like of the all the professionals
like the architects , engineers ,contractors and sub contractors have the risk free
contracts for all the work packages towards the execution works of the hospital project
with a final set of construction drawings for site development , structural , exterior ,
interior , plumbing , electrical (including fire alarm and security details), HVAC, civil
and allied , and landscaping transforms the building into a good environmental hospital
for the community and the decision making members of the board members. A copy of
set of construction drawings are passed to the respective contractors. These approved
documents are developed for the final drawings and the specifications in the respective
work packages areas of expertise towards beginning of the contracting.
Once the final prints and documents are approved, the copies may have to be
approved by several other government agencies. Architects review the plans for fire and
safety regulation, handicapped accessibility, earthquake protection, etc.
According to (Bogers, 2008), ‘‘A good brief explains what the client needs,
desires and expects from a project.’ Architects for the hospital project were supported
with the all the documents for the agencies to start the process of contracting with
‘signed-off’ documents in lieu of the board members.
Cost becomes definite and final only when the contractors state the sums for
which they will do the work drawn and specified by architect, and the board of
members accepts the offers of some of them. To prevent the suspicion of favoritism,
contracting is conducted for competitive bids. The reasoning behind these competitive
bidding is to obtain the economical cost and to benefit for the budget of the hospital
project. These practices of contracting help the board members and they have
implications towards the construction of the hospital with all the contractors and the
‘‘The ideas proposed for ways to develop trust in construction projects as seen
from project findings have important implications for not only the clients but also for
the main contractors and sub-contractors.” (Malik, 2007) also describes that practice
leads to the trust building, dependence, and open professional relationship.
2.4.1 Advertising and Bidding the project
Carefully prepared bidding documents and detailed procedures are necessary to
obtain all the potential benefits of the competitive bidding system.
These kinds of bidding system were earlier benefited in a construction project as
depicted by (Franco et al, 2007). ‘‘The proposed framework has been tested as a
decision support tool on a power plant project. ’’
A brief description of the project, and any conditions which are attached to
preparing, submitting and opening the bids are also included. In addition, the architect
should prepare a list of firms to be invited to bid. Those potential bidders who are
definitely interested in submitting bids on a project as a result of notification are
According to (Chan, et al, 2004), the success of winning is the team effort for
bidding, ‘‘Partnering is perhaps one of the most innovative developments in
delivering a project efficiently and reducing construction disputes. Partnering
provides a sound basis for achieving a win-win situation and implementing
synergistic teamwork.’’ According to them, the certain requirements were to be met for
successful takeover of the project by the contractors with goal in the construction of
Usually, a deposit is charged to anyone requesting a set or sets of documents. A
deposit helps limited number of sets of documents the architects must produce, it
prevents most persons from requesting documents out of sheer curiosity, and it helps to
guarantee the return of the documents. The deposits are usually refundable to
contractors making a bonafide bid. In large projects, it may be advantageous to allow
the contractor up to six weeks. There are literally hundreds of kinds of line items in the
bill of quantities that must be computed and prices secured. Contractors also must get an
estimated cost of labor for each of the trades involved; this also helps for the project
officer in building the honest trust towards the final settlement of payments towards the
payments at the time of payment cycle of the month for smooth running of the project
as noticed by Malik (2007)
2.4.2 Receiving Bids
The treasures or the project officer should place the date and time the bid arrived
on the outside of the bid package. The package needs to be put aside until it is time to
open all the bids.
2.4.3 Tabulating Bids
Bids are opened, information pertaining to each bid is thoroughly checked, and
All bids forms should be made available to the interested parties who care to examine.
At least two ‘official’ tabulations should be made on the spot, and these should later be
checked against each other and against the original bid proposals. No bids should be
returned unopened to the sender for the any particular reason as stated by (Sang-Hoon,
2.4.4 Analyzing Bids
Relating to the bids of the construction of building especially, the authorities
must accept the ‘lowest and best’ bid.
“The data analysis results show that individual change management practices
elements have different levels of leverage in helping to control project change cost
and that using change management practices is truly helpful in lowering the
proportion of change cost in project actual cost.” Cost is most approachable aspects of
winning the project for the construction project management as stated by (Sang-Hoon,
Sang-Hoon (2008) states that the data analysis is the very crucial for several
base bids are for project to be on control.
Necessary things required for determining the lowest bid and best bid on a
particular bid returns that at least the following questions to be answered:
1. Requirements for bidding been met?
2. Bid received on time?
3. Is the required bid bond included in the correct amount?
4. Is the proposal in proper form?
5. Are requested bids on alternatives included?
6. Does he have access to the necessary equipment?
2.4.5 Awarding and Execution of Construction Contracts
According to the Guidelines for Design and Construction of Health care
facilities owners (2006), after the bids have been received and examined, contract
awards are approved by a resoultion pass by the board members. Board members are
required to review the contracts prior to the board members approval . The bill of
quantities or specification cannot be changed prior to rebidding . Negotiations are
permissible to clarify or correct the agreement. Any new works are rebid legally for any
change order in the contract. Architects intiates the change order for any change of
contract. All the change orders are to be approved by the members of the board .
The Guidelines for Design and Construction of Health care facilities owners
(2006) also stated that contractors common practice is , either with the bid or following
the bid opening, to submit to the architect a list of subcontractors they propose to
employ on the project. The progress schedule of works for the project is the contractor’s
responsiblility . The architect is responsible for ensuring that the general contractor
holds regular meetings of the prime contractor and subcontractors . The design and
construction issues are to be addressed to the architect at regular intervals for a better
quality of the project. Job related meetings are the key to success on the originally
2.5.1 Ground Breaking
Shortly after the board has awarded the prime contracts, but prior to the actual
construction beginning, the board will want to hold a ground breaking ceremony.
Normally, key individuals will get short speeches thanking the individuals and
groups that have worked hard throughout the planning and design process. The
following are just a few of the individuals who can be invited: Board members (present
and past), administrators of the local community , elected officials , certified and
classified staff , and members of all ad hoc committees. In addition to these individuals,
the architect and prime contractors need to participate.
A ground breaking exercise can be used for different purposes, such as public
relations, thanking the individuals working on the project, developing the anticipation
and excitement of the project, and serves as a tangible signal to begin the construction
Normally, after the speeches and introduction, individuals will be invited to use
a spade to turn a symbolic shovelful of dirt. Drawing, models, and 3d rendered images
are displayed on the canvas. A ground breaking ceremony is an excellent vehicle to earn
community acceptance of the total building project.
2.5.2 Construction Administration
Traditionally, the architect or an employee of the architect is responsible and
observes the project on-site to protect the owner against the defects and deficiencies in
the contractor’s work.
In theory, the architect turns the contract document over to the contractor, who
in turn, performs in accordance with these documents and claims completion of the
work. In practice, however, the best inspection is continuous inspection of the work on
According to the AIA contract documents, the architect is not responsible for
exhaustive or continuous construction administration.
The Guidelines for Design and Construction of Health care facilities owners (2006)
writes that the best way for a board to ensure that the necessary construction
administration occurs is to pay the salary of a full-time on-site representative from the
architects firm to perform these functions. If this is not acceptable, the board can hire a
clerk of works. A clerk of works ensures that the owner has a construction administrator
on the premise at the proper times and that the inspections are performed in a manner
that confirms the reported results. He supplements, rather than replaces, the work of
Nirmal et al, (2006) wrote, “Specialists construction professionals on the site
play a vital role in the absence of the Architect on-site .The study provides field level
experiences from which the inexperience construction site professionals could learn
the instances of conflicts and not repeat the mistakes in their project.’’ And also The
construction professionals can be on the board at any number of points in planning
/construction process. It is important that the work of the architect should not be taken
over by the construction manager and vice versa.
Iyer and Jha(2005) wrote, “Critical success factors obtained by the analyses
are: project manager's competence; top management support.”Also he is under the
impression that the coordination between the construction project managers for the site
related activities plays a vital role. The managers were involved in the construction
quality , reduction in costs, and an acceleration of construction schedule of the hospital
projects decision to choose construction management over the general contractor
(Linda, 2008) supported the argument for design and construction management
with the following , “ The reason for using an integrated design-build delivery
method, in my mind, is that the client can benefit from a side-by-side working process
involving the design and construction teams, engineers, property management,
energy-analysis folks, and subcontractors.” Also he is under the impessrion that
various other factors of the construction activities like cost efficiency, multiple low bids
watch dog and claim reduction and time savings ,
The construction project managers will be on the site daily at varying times ,
observing , taking notes , and even photographing the progress of works on regular
basis. These individuals during the inspections must be familiar with established
construction practices and also required to interpret the architectural drawings and the
2.5.3 Change Orders
Change orders can occur if the architect or engineer omitted the approved design
factor(s) that requires. Often, the owner initiates a change to the originals plans. (Sang-
Hoon, 2008) pointed that change orders are expensive, because the contractor normally
calculates at least a 15 percent overheads charge and a 10 percent profit charge. Often, a
prime contractor will tack on a 5 percent or more profit charge to the cost of their
Chen-Yu (2007) identifies the root causes for the project to get into trouble with
change orders. “Three parameters, including ungovernable uncertainty, degree of
lock-in and amount of money under dispute, are identified.” Also, under the
impression that protective contracts of the payments were not to be stretched for the
benefit of the project
Payments to contractors are commonly made on a monthly basis .These
payments are the crucial part of the projects to run smoothly. Francis (2008) suggested
adopting for risk free method for the progress of the project. “Bayesian analysis can be
applied to construction contract risks, as part of a more systematic management of
contract risks, to achieve better rigour in risk analyses.” If the payments are approved
by the board members, the cheque is issued by the treasurer. There is a common
practice to retain little percentages of request in each cheque until the contractor has
completed the project.
2.5.5 Building Activation
Building Activation refers to that transition period when the construction has or
is nearing completion, but prior to the building being placed into performing service to
During this period, The Guidelines for Design and Construction of Health
care facilities owners (2006), points out that individual pieces of equipment, as well as
entire system, are tested to make sure that they are working as per the design and
specifications intended.In addition, various systems of the building, such as the
mechanical, electrical, support laboratory rooms are checked to assure that they function
together. Heating , cooling and plumbing systems should be drained and throughly
cleaned after activation, then refilled for operational use.
2.5.6 Punch list
According to Sang-Hoon (2008), when a contractor determines that his portion
of the project is completed, he notifies the architect and the construction project
managers in writing. All the items that do not pass the inspection are placed on a list
called ‘snag list’. The contractor then uses this list to find and correct the deficiencies.
Once all the items have been completed and corrected to the standards of architect,
construction project manager and the board members, the contractor has completed his
This chapter examines the approach of the present study on Planning
Stages in Project Management : Development of the 100 – Bedded Hospital
Construction Project. The following topics are briefly discussed
1. Statement of the problem
2. Purpose of the study
4. Aims and Objectives of the study
5. Research methodology
6. Sample Collection
7. Area of the Present Study
8. Importance of the Present study.
3. 1 STATEMENT OF THE PROBLEM
As stated in the earlier chapter, in the construction projects unique challenges arise
when the construction project relates to a hospital. The purpose of this study is to
produce a reliable technique for identifying the adequate project management stages of
the construction project of a hospital, in order to have a proper project management plan
during different stages of the project life cycle in the 100 Bedded Hospital as well as in
any construction industry. This study helps all the new comers in the construction
industry on the project and also the existing personnel working on the construction
project, to have a clear understanding of the construction stages already completed, any
backlogs, actual position of present stage and balance stages to be completed.
Projects in India are frequently late: This is due to improper budget, poor workmanship
during the formation of construction site, materials. Conflicts are in every project and at
different stages, resulting in litigation and arbitration among the people working in the
project with discouraging regularity. The aesthetics of the unfinished construction
environment are subjected to immense dissatisfaction in the popular press in India, and
this is often reinforced by more publicity in the media. This reflects lack of control over
the management of the project and from the application of outdated ideas in the
3. 2 PURPOSE OF THE STUDY
This study considers the present state of affairs in 'Project Management and
Construction'. It discusses the reasons for the lack of advancement in the field and
proposes measures, which can be taken to improve upon the situation. It suggests that
key changes in approach are necessary. The configuration of comprehensive remains
dedicated to the development of promotion, coordination and dissemination of works in
the area of construction.
This study considers the ‘Planning Stages in Project Management: Development of the
100 Bedded Hospital Construction Project in Hyderabad, India’. It discusses the various
stages of the 100 Bedded hospital project through out the life cycle of the project.
Project Management plan and feedback are the priorities and methods needed to
identify the objectives for the project team members. To achieve this, the present study
has been under taken. It is also intended to study the relationships with in the project life
cycle, and to come up with a solution in the field of construction project environment.
3. 3 HYPOTHESIS
The hypothesis of this study is that the construction industry could improve its
performance on all of the grounds mentioned, if project management stages are created
to the required level of detail, of what and when activities have to take place with proper
project management which address time, cost, function, quality, resources and thus
3. 4 AIMS AND OBJECTIVES OF THE STUDY
The aim of this study is to highlight a workflow and evolve the frame work of project
management in the construction industry. It also includes mixture of activities at
different stages of the project in terms of project management at site. The research aims
to provide a model that can be practically applied to different types of construction
projects. Keeping in view the aim of this study the following objectives have been
• To study the nature of construction-related project management, planning,
processes and its and consequences on the life cycle of the project.
• To study step-by-step project management stages of the construction process,
such as planning, design, management, finance, costs, health and safety, etc.
• To study how the effective the project management plan can be effectively
implemented at different stages of the workflow during project life cycle.
3. 5 RESEARCH METHODOLOGY
The research methodology selected for project management project of this construction
project comprised comprehensive literature review, a postal questionnaire to the
construction industry practitioners and a 90-minute telephonic interview and analysis of
the data collected. The questionnaire consisted of two sections:
1. Section I - Gathered general information about the respondents.
2. Section II -Gathered specific questionnaire specifically for specialists or experts
associated with this hospital construction project.
The questionnaires were sent to five construction practitioners involved in the project
by post. All respondents were contacted beforehand to make sure that they were
familiar with objective of this study and asked if they were willing to join this study to
give their feedback about the activity that took place during the time of this project
execution. After a week of waiting period, their feedbacks were received.
3. 6 SAMPLE COMPOSITION
The respondents were all industry practitioners that included:
1. Project Architects,
2. Document Controller,
3. Construction Project Manager
4. Contractors and
5. Board Members (i.e. managing director and senior associate). They all had
worked and had been involved during the initial stage of the project and up to the
closure of this particular project. It should be noted that the sample size is relatively
small in this survey.
3. 7 AREA OF THE PRESENT STUDY
Healthcare is the sunrise sector globally especially in a country like India with ever
increasing population. The Indian governments in liaison with large corporate groups
are pumping crores of rupees into hospital constructions that are being promoted
aggressively in every corner of the country. As part of its strategic plans the
‘PATNALA ASSOCIATES’ initiated the establishment of a multi-specialty
government hospital in Hyderabad and constructed 100-bedded hospital at Hyderabad,
India, beginning in the 2000 to 2004 ending. Project implementation, which was
commenced, was based on designs drawn up by Project Architect at Patnala Associates.
Designed strictly in accordance with the architectural principles and to the regulations
of APH&MRIC, the hospital accommodates all the major medical disciplines supported
by the latest generation radiology and imaging equipment. This 2-storeyed and 67000
sqft state-of-the-art multi-specialty tertiary-care facility is designed to house 100 in-
patient beds, 5 Operation Theatres and supported by other facility rooms etc. Following
an in-depth analysis of the user scenario, the design team submitted a schematic plan
and the structure plan for the development of the entire facility. Based on designs
submitted by Patnala Associate design team, the construction activities of the project
and project management at the site level had been carried out.
This Hospital had been constructed on a generous 25-acre, gently undulating site. The
architecture of the building adopted cost-effective design technology, which was aimed
at economizing on the operational expenses of the hospital systems and in response to
the local building regulations requirements that all building reﬂect the traditional
architectural style of the region. The design of the proposed hospital building is a blend
of local architecture. Having looked into the complexities of constructing a hospital and
its management and having myself involved in one of the projects of hospital
construction, it has inspired me to undertake this study. This study aims to highlight
different common management plans in the construction of a hospital building.
3. 8 IMPORTANCE OF THE PRESENT STUDY
This study presents an approach to the integration of site-related activities into the
planning and scheduling of the entire construction project. The study starts by briefly
studying some common project management methods used by construction firms and
architectural firms in the planning and scheduling of site activities by questionnaire,
interviews and observation. This could help the construction projects to end
successfully. Based on the feedback and results gathered, a virtual-reality-based model
is proposed and presented at the end of the appendix. The proposed model uses both
knowledge-based simulation of the work progress of any building construction, logical
interpretations and visualization capabilities, to achieve the desired goal.
4.0 DATA INTERPRETATION AND ANALYSIS OF THE
PRESENT STUDY UNDERRTAKEN
In this chapter, the findings are done according to the planning stages of the
project as developed into reality. The questionnaires were initially sent before the
telephonic interviews are conducted. This approach for quicker feed back had been
taken with the project personnel who were most significant people involved in the
project from initiation stage of the project to the closure of the project.
1. Project Architect,
2. Document Controller,
3. Construction Project Manager
4. Contractor and
5. Board members representing the Government of India.
The significant activities of the project were gathered according to the developmental
The various stages identified are
STAGE-I - BID STAGE,
STAGE-II - FINAL BID STAGE,
STAGE-III - PRE CONTRACT STAGE,
STAGE-IV - SITE STAGE,
STAGE-V - POST CONTRACT TEAM
The data gathered from the above stated prominent personnel had been analysed and
interpreted in the following manner.
In a project, during this stage of the project it is very essential and important to
recognise the close connection between architectural design and construction. In a large
picture, design is a process of creating the representation of a new facility, usually
represented in the form of detailed architectural construction plans during this stage and
specifications. Construction management planning is a process of identifying activities,
work break down structure and resources required to make the final design into physical
reality. Accordingly, Architects and engineers imagine and design to construct the
facility and the Construction project managers to implement on the site during the
construction of the project. In both design and construction stages of the project, a
number of different relational tasks have to be preformed according to the precedence
during the construction project among different work packages. During this stage,
keeping this in mind the maximum numbers of risks have to be identified and avoided at
the early stage of the project. For common projects of moderate size and complexity in
the design and construction, the owner often makes use of a designer. The Project
Architect prepares the detailed plans, elevations, sections, necessary detailed drawings
and specifications of the project for the constructor to build the facility. The Project
Architect plays significant role in the absence of the owner to administer the project
implementation during construction. And for construction of the new facility, the
general contractor is responsible, though the work is taken over by the sub contractor
for the project. Despite the fact that, the conceptual design proposals may be formal or
informal and can be recognized by a series of actions involved in the design
formulation, design data analysis, date search, decision making, specification writing,
and finally modification. On the other hand, in the first instance of the development of
the facility, these actions are extremely interactive to the functional needs. Many
iterations and changes of design are likely to happen for the basic functional
requirements for simplicity and comfort, design concepts for appealing and financial
constraints of the project. The analytical tools applied to the solution for the problem of
design and construct at this stage may be much unfinished during the later part of the
During the project of the present study the concerned important personnel have
stated and identified the following activities.
A) Architectural Issue during the project implementation
B) Planning and specification documents
C) Payment Cycle
D) Safety Plan
A) Architectural Issues
1. According to the data gathered from the Project Architect, during the designing
stage of the project, some of the areas like the nurse stations, wards and
physiotherapy rooms in the floor plan have been changed three times, after the
initial plan was approved for construction. This was due to the delay of project
specific requirements given later by the Board members to the Project Architect
to incorporate the details of the specification not given in the tender stage. Thee
delay in the approval of the project design by the Board members and delayed
the supplying some of the drawings are required with specifications had caused
the delay of the project to begin on time. This was identified by the Project
2. During this phase, developing the required set of construction drawings took
considerable amount of time to prepare than the scheduled plan; this had
implications at the bidding stage of the project. ‘This has resulted in the change of
time frame schedule of the project time lines’. This issue was identified by the
Project Architect. This was due to lack of sufficient man power on the proposed
3. Project Architect had proposed specifications of material for the floorings at
various places on the floor according to the respective rooms for the project. As
the contractor could not get the required material at the site on time, there were
some delays. This issue was identified by the Project Architect. This was due to
the supply chain which could not supply the required material to the contractor.
B) Planning and specification documents
The process of development of a construction plan is exceptionally similar to the
development of a good facility design by the Project Architects and contractor from
project to project. The project planner at this point of time is required to prepare the
budget sheets and the dependability’s of different options while at the same time
underwrite technical feasibility for the proposed project. Construction planning during
the execution is more difficult in so many ways, since the building process is very
dynamic, as the site progresses as quickly, the physical appearance of the facility
changes over time as construction progress day by day and hour by hour. On the other
hand, on the project to project basis the construction operations tend to be to the
expected standards, similarly structural and foundation details significantly differ from
the design point of view. For examining the alternatives the design and construction can
start at the same time, which would be useful for examining the alternatives paralleled
to the value engineering purpose. The review process with designs can be carried from
planning to design.
1. During the Planning and Development phase of this project, planning and
designing, specification documents began to define user requirements for better
building performance. When the entire project delivery process was documented
in a consistent manner on the paper, a sequential perspective was created that
explained the iterative process of determining the agreed-to project requirements
at each step of the development process. It was identified by all three team
members of the requirement i.e. Project Architects, Construction Project
Managers and Contractors that relevant planning and specification documents
and necessary information during the bid stage of the work packages were
provided to all the contractors involved in the project.
2. Administration and financial staff
The administration and financial staff was an outside controlling body of this
project. They were part of Board members department and responsible for the
documentation works and cost control management of the project. It was found that
administration and financial staff was controlled by the Board members. The
Construction Project Managers of the project are guided by the Board members, that
the funds and resources could be increased on the project to complete the project
within the permitted budget. This issue was identified by the construction project
managers. This was due to project setup of internal communication at the beginning of
C) Payment Cycle
1. The payment cycles were under the control of the administration and financial
department. It was identified that there were irregular payment cycles in this
project. Contractors did not get the payments on time during the progress of work.
This is one of the critical issues of the project, which affected the work. This was
identified by the Document controller of the project that no proper payment
cycles were defined in the earlier stages of the project. Two payments cycles could
be necessary for the smooth running of the project of this size.
D) Safety Plan
Safety is important to everyone. Job site safety is the responsibility of the contractor.
Health and safety is prepared by construction project managers before the contractors
are on the board to manage during the construction phase. The principal contractor is
then required to develop the health and safety plan before work starts on site and keep it
up to date throughout the construction phase.
1. During the construction of this project, two site accidents took place where two
labors died during the excavation phase of construction. It was stated by the
construction project manager on the site that no safety plan and procedures were
adopted before the accident occurred at the time of construction.
2. Two fire accidents occurred during the construction stage of this project as
stated by the contractor’s subcontractor. The monitoring of the subcontracts
standards was not done prior to work commenced on the construction site by the
contractors. It was also stated and identified by Document controller and
contractor that no insurance system was existing for some of the work packages
provided by the sub contractor. These incidents delayed and affected the schedule
of the project as identified by construction project manager and also stopped the
labor force to work on the project for some duration, till the subcontractors raised
the quality standards.
Design Project Managers and Construction Group personnel work closely from project
initiation through final inspection. Coordination between the staffs of these sections of
the department is key to successful project completion.
1. During the execution stage of the project, it was identified that the coordination
between the work package contractors are poor at the time of execution on the
site related activities by different contractors. It was found that by the
construction project managers that contractors, project managers were not
experienced persons and lacked the knowledge to coordinate with other
contractors; project managers have hindered the progress of work on the site.
This aspect hindered the progress of the site. This was identified by the
construction project managers of the project and Project Architect.
4.2 STAGE –II
FINAL BID STAGE
This is the final stage of the bidding process. During construction the central of focus is
to predict the cost estimating of any changes that are planned. There are many reasons
for the changes to happen like the drawing errors, code issues, contractual terms and
user generated changes. At the final bid stage the drawing to one hundred percent
complete by the architects for the project. The estimate for the changes is often adjusted
to account of the design changes for the final estimate. This is for the out of scope of
works for the project at the time of bid. During the project of the present study, the
concerned important personnel have stated and identified the following activities.
A) Cost Management
B) Value engineering
C) Waste management
D) Risk Register
A) Cost Management
The Board members directed certain modifications during this stage of the project.
The settlement of these modifications not only increased the cost and time but
also directly affected the work pattern. It had implications on the unchanged work.
It was stated by the Project Architect that the impact portions on unchanged work
of a modification were very difficult to determine the impact portions of unchanged
work modifications for construction project managers and contractors. The
construction project managers pointed that the scope of impact was very broad,
intangible, and susceptible to different situations.
B) Value engineering
Value engineering process may be mostly defined as an organized approach during
the course of the project in identifying unnecessary costs in design and construction
and in requesting or proposing alternative design or construction technology to
reduce costs without sacrificing quality or performance requirements of the project.
It usually involves the steps of gathering relevant information based on the study
and existing data, searching for creative ideas in the similar field, evaluating the
capable alternatives, and proposing a more cost effective alternative for the design
and construction. Value engineering approach is typically applied at the beginning
of the construction phase of the project life cycle.
1. In this project, value engineering workshop was conducted by the Board
members. It was stated that Board members wanted the Project Architect or
consultants to develop and coordinate value- engineering tasks that identified
potential cost savings for the project. Cost savings that have more of an impact on
the overall project budget or schedule typically were identified during this phase
when the appropriate value engineering systems. As part of the finances of the
project, corruption on a construction project increased projected costs; It was
identified by the Document controller that it had an adverse effect towards the
advancement of this project.
C) Waste management:
The presence of waste deposits on a potential construction site can have substantial
impacts on the surrounding area. Waste management is the responsibility to ensure
that all waste produced during the construction works for the project are handled,
stored and disposed of in accordance with good waste management practices,
regulations and requirements. Contractor has to develop a site waste management
plan with recommended mitigation measures before the start of the construction
1. Hazards associated with health-care waste management and shortcomings
were identified during this phase of the project by Board members. It was
identified by Board members that the disposing system did not hold good for the
user and local community due to lack of thought process at the time of design
phase of the project. This has resulted in creating the environmental pollution to
the community. It was identified by Board members that the biomedical
wastes produced by the hospital did not have any definite action plan for
expansions within the project.
D) Risk Register
The Risk register is maintained in relation to a specific activity or plan of action. This
register holds all the lists, all the identified risks and the results of their analysis and
evaluation for the purpose of the project. The risk register is put in place during the
start up of the project. This is to readily record project risks, including any prominent
risks in the Project Brief. It is an important component of the project risk management
framework in which the problems may arise during the project and affect adversely
the delivery of the project. Also the anticipated benefits and actions are captured to
decrease the probability and the impact of the particular risk.
1. Risk register for this project was developed in the initial stage itself during this
stage of the project. It was said that all issues and risks were raised by anyone
involved in the project throughout its lifecycle and were to be recorded
regularly. Unfortunately, it was identified that it was not updated on a regular
basis at regular intervals. This issue was identified by the Board members with
PRE CONTRACT STAGE
Pre contract stage is the stage to explain the site staff in detail the scope of works that
have to be carried or already carried out by their employer and seniors, before the
contract is awarded of the bidding process. During the project of the present study, the
concerned important personnel have stated and identified the following activities.
B) Progress meetings
1. During execution of the project, the tasks on the site activities related-
Architectural Issues were required approvals from the board members. It was
identified by the construction project managers that the decisions to be given by the
board members took more than the required numbers of days to give approval of
change order for the work to commence on the site.
B) Progress meetings
1. Monitoring services were done by the construction project managers on the site and
the appointed site Project Architect during project execution and implementation
stages ensures that the project progress was in accordance with the approved plan,
both in physical and financial terms. This was measured against the planned verses
actual by software like MS – Project. The above two issues were identified by the
construction project managers that these were achieved through network
techniques based on the project specific information system, project communication
plan, weekly progress review meetings, safety assurance requirements, quality
assurance requirements policies and procedures.
The general information about the construction site is usually available at the planning
stage of a project, it is significant for the all the team members like architects,
construction manager as well as the contractor to visit the site. All the team members
involved on the project would be benefited on examining the topography of the site
for the facility. A bad design layout can cause construction problems such as
inadequate space for staging, limited access for labour and material and for the
construction methods. Design and construction inputs are important in the layout of
the facility. The construction manager and the contractor visit the site to gain some
insight in preparing or evaluating the bid package for the project. They can also
observe any interference of existing facilities with construction and develop a plan for
site security during construction.
During the project of the present study, the concerned important personnel have stated
and identified the following activities.
A) Construction Site Environment
B) Electrical and Mechanical
C) Construction Project Manager
E) Interpersonal Relations
A) Construction Site Environment
1. At the time of construction stage, new construction project managers were
constantly replaced on the site because of either internal problems or politics. These
new recruits of the project took much time to understand the project specification
and the drawings. And also the pressure of work on the site resulted delay on the
construction schedule of activities. This was identified by Project Architects.
B) Electrical and Mechanical
1. During the site stage of the project of the execution, the execution at the site level
as per the coordination drawings became a problem for electrical and mechanical
contractors and this had impact on the proceedings. This was identified by the
construction project managers. This was due to the fact that coordination
drawings were not developed during the previous stage of the project.
2. During this phase of the project, the construction project managers found that
many modifications of the work plan changed when superimposed upon the
original drawings. The construction project managers at the site modified the
specifications schedule in such a manner to minimize delay under the given
requirements. It was also identified that the revised drawings and specifications
were thoroughly reviewed in relation to the existing job plan on the site with the
specific contractors of the project to meet the dead lines of the project and the
C) Construction Project manager
The construction project manager is the most important and vital person for the success
or failure of a project. The project is controlled by the project manager in the
departments like planning, organizing and controlling of the project. At the same time,
the project managers are entertained to authority and take control to manage and
organize the resources required for the project and to complete.
1. In the present project, the construction project managers played an important role
during this stage of development of the construction. Retaining the employees with
good knowledge has costed additional unexpected costs in the project. During this
phase of the project, the human resources department intended to appoint
technically qualified staff for easy execution of the project, familiar with all the
work packages to coordinate on the site for easy execution of purpose, as there were
lots of opportunities in the construction industry, it was stated by the human
resources department that the many construction project managers have moved out
of the project for their own individual career growth.
1. During this stage of the project, it was identified that payment claims had been
rejected or at least diluted by the contractor causing a delay in the project, it was
identified by Document controller that there were numerous other combined
issues which resulted in delays during the execution stage of project as discussed
earlier with payment cycles .
E) Interpersonal Relations
The successful project manager must be a proactive leader, the project management
team members are required to work together, assembled from different organization to
work on the proposed project. There may be miscommunications among the team
members with regard to the roles and responsibilities in the project team. These troubles
of the team members must be resolved quickly in order to develop an effective
functioning team. The project team contributors are supposed to have good
interpersonal skills and should over -come serious communication issues at the earliest
stage. The problems between the team members should be resolved and dealt with
immediately. The ultimate results are maximized about controlling the groups and
individuals when things go miserably on the wrong side of the project and lose control.
These are the actions to be determined the project organization.
1. During this stage of the present project, the coordination among the work package
contractors and managers was very poor, There were numerous site related
activities that required coordination by the contractors and the construction project
managers. Some of the construction project managers as well as the contractors had
little knowledge or no site related experience, lack of proper communication and not
having good knowledge of the drawings had led to minor conflicts on the site. This
was identified by the Construction Project manager.
POST CONTRACT STAGE
Post Contract Stage is the stage that provides the means to ensure that the contract
which was signed today at the end of the project would still represent value for money
of the project. During the project of the present study, the concerned important
personnel have stated and identified the following activities.
A) Cost management liability Period
B) Completion Certificate
C) Lessons Learned Report Submission
A) Cost management liability Period
1. Construction project manager ensured that all contractual obligations related to the
project have been met and closed. As part of the project team, he was responsible
for contract management and also answerable to the board members. It was
identified that two teams have been responsible in managing the contract
satisfactorily through out the life cycle of the project. Those are Construction
project managers and Board members. As part of managing the contracts, the
construction project managers in concurrence with the board members ensured that
all the contractors have fulfilled their contractual obligations before the closure of
B) Completion Certificate
1. Based on the periodic observations done on site by the Project Architect in
accordance with specification standards of the site, it was identified that a joint
signoff was done with the construction project managers and contractors on all
the work packages for completing the work. Project has been completed by the
contractors on the site with defects lists (except for minor punch list items
specifically described in this certificate with estimated costs) so that occupants
could occupy for the purpose for which it was intended.
C) Lessons Learned Report Submission
1. During this stage of the project, it was stated that the lesson learned report was
submitted by construction project manager to the board members representing the
government. This report highlighted the vision needed by the construction project
managers regarding the planning, design, construction and activation phases of the
project. It also highlighted that no one had lost the sight of the ultimate goal.
Additionally, important strategic, operational, and financial decisions made
throughout the project had been submitted. This was been done keeping in view that
this kind of project report might be useful for reference to either the board members
or other construction personnel who would be involved in similar kind of projects in
5.0 KEY RECOMMENDATIONS
In this chapter, with hypothesis tested the following recommendations have been
proposed in the present chapter.
A) The selection of an architect with most consistent experience in designing hospitals
and also with strong construction background is the single most important decision for
any member of board for the success of the project .
B) The drawings and the specifications have to be made by the architects and the
specification writer well in advance for the bidding stage, and construction project
managers and the contractors have to review prior to the start of construction on the site.
C) Using of latest software’s like BIM (Building Information Management), AutoCAD
and Microsoft Project, and people skills with the latest use of product for designing
helps to reduce the time, paperwork and accurate results for better output. This also
helps the redundancy in any point of designing and planning stages.
A) Planning the entire facility with all the requirements of architects are necessary and
would be very essential for the board members to take a decision in a single go for all
approvals and for the local community during the construction. This also helps the
project to progress in an efficient manner with in the required time schedules. Even
before the construction begins on the site, the method statements for all the activities
and the safety plan for the project shall be in place. This helps the project to run
efficiently for all the stages of the project.
A) The board members should use cost analysis methods for right decisions
concerning all possible options. The main goal is to show financial implications
over the project would differ for each alternative and make it to the best use for
practicable consideration with in timelines, comparability and flexibility.
B) Lack of financial appropriations for maintenance after completion of the
construction project is a major problem. Budget for the project with adequate
buffer would be necessary for all the possible project related works.
A) During the construction stage of the project, there should be well experienced and
knowledgeable people like architects, construction project managers and contractors and
those only are to be recruited for the project.
B) During the time of construction, health and safety plan to be implementing well
before the construction of the site.
C) The main contracting work packages like mechanical and electrical should be carried
by single contractor. Then only coordination issues on the site as well as preparing the
drawings for the project could be easy.
A) Get every team member together as early as possible on the board of the project and
evaluate and identify which issues are to be resolved on priority basis, for different
stages of the project. The contractors on the board of the project should control the
subcontractors. The subcontractors on the board of the project should be handled with
utmost most care at the time of construction by their respective contractors, and also
they are required to follow the guidelines of the project.
A) Increasing number of the people walking to the hospitals is high in volume,
especially among the aging population. The entire facilities with excellent
architectural solutions for the convenience of these people are to be provided.
B) Risks are to be prioritized according to their importance of pressure on typical
project with explicit objectives in terms of cost, time, quality, safety and
ecological sustainability, and then scrutinized from a joint perspective of project
members for the life cycle of the project.
C) If discovery begins before the investigation commences for dreaming the
construction of the project, the probability of finding a successful direction for
the project only increases. The amount of time spent on planning and design is
usually proportional to the overall scope and planned duration of the project.
D) Hospitals that demonstrate good design and construction quality with good
operational efficiency would have good bench mark for the business growth.
Anticipate designing and planning needs of the future based on possible trends
of the future developments involved in both the hospital and in the project
management of construction, but not on the trends of the past .
6. 0 CONCLUSIONS
Appointing the good architect with experience in designing could be useful for
high-quality mental picture of the project.
Developing the drawings much early for the project with latest software can save time
for the contractors to bid. Construction project managers should control the contractors
at the site level execution of the project for successful hand over of the site to the user
with in the time lines and cost of the budget. The construction project management team
should be on the site, having to coordinate to the best of the abilities and capabilities
with all the work package contractors during the project execution of the site.
Risk register, Lessons learned register, and Health and safety plan have to be in place
before the construction stage.
The board members are advised to appoint the experienced and talented personnel for
the construction project with the correct remunerations at the beginning of the project
and incentives at the end of the project for the excellent closure of the project on time.
This helps the project to be on target schedules and time lines.
In this study, project management various stages of construction and project
management are proved to be more important for the construction project managers
who are involved in the project life cycle. The construction project managers on the site
have got the control over the project.
The London’s tube map was developed over 108 years. As inspired from the
London’s Tube map, a Construction map graphically representing various stages of the
project and the main activities of the construction was developed for the convenience of
the people involved in the project. This was similar to the London’s tube map with the
logical interpretation of activities happening through out the project and from data
interpretations at the time of interview. To develop these activities as to how they are
linked to one another among the other departments of development of construction, free
downloaded software from internet by name Concept Draw MINDMAP 5 software was
used as a tool. The final output of Project management stages in the project was
developed in the AutoCAD software used by Architects for developing the drawings.
Construction map, which is self explanatory with the color coding and the legend helps
all the people working on the projects with ease, this will help on the activities of the
project at any given of point of time . The activity that takes place at the time of
construction are identified according to the stages of the construction of the project.
Project management activates of the site stage were also identified and high lighted,
which are critical for the project management in the construction of projects. To
develop this map all the inspiration was the London’s Tube map. Though, the thought
process for developing this Construction map was at the time of submitting the
proposal, this map was developed during the course of the dissertation during the
findings. This could be one of the self-motivated suggestions for the development and
successful closure for any project in the construction for every individual working on
the project. This construction map can further be developed with GAR (Green, Amber,
and Red) model for the activities. This can be developed with the help of software
developers as an enterprise software for the construction projects.
Reflecting back to the aim and objectives to evolve with a frame work of project
management stages is supported by this construction map. The construction related
consequences on the life cycle of the project, while identifying step by step project
management stages and following the project management plan can be implemented at
different stages of the project life cycle applying proactively In the general practice of
the construction. Planning Stages in Project Management is supported with a
Construction map in the APPENDIX E.