Link to thesis - Concept - NTNU

User involvement also generated expectations. All desired features and volume of the newhospital building was not possible to combine within the allocated recourses. As a result ofthis the process analyses of the second phase had more elements of a top-down approach withmore intensive involvement of leadership in the first steps to define goals, priorities etc, andan emphasis on providing more facts when starting the group work. The group work was alsomore focused due to a more defined mandate owing to focus on critical aspects and processes.The learning curve for all parts involved in the process analyses in phase 2 was quite steep.One insight was that there was need of more defined direction, priorities and goals in the earlysteps of the process analyses. This also includes consensus related to facts and definitionssuch as in the HFP.The transfer from analysis to decision making proved challenging for two reasons: Firstly,user involvement also generated user expectations. Secondly, the decision process required ahigher level of detail, while the process analysis by nature was more conceptual. On aconceptual level, most stakeholders could agree on desirable solutions. As the level of detailincreased, so did the awareness of different group interests. The pressure to summariseprocess analysis results into straight forward decision supporting facts was related to projectefficiency. The design and construction project needed clarifications to be able to continue.Lack of clarifications meant delays and increased project-related costs. Project efficiency is akey issue when explaining why the process analysis was carried out as it was.An overall objective of the process analysis was effectiveness in terms of a suitable futurehospital building. One aspect of effectiveness of a hospital building project is the cost andquality level of the operation in the new building (the processes within a new hospital). Thesame cost and quality measures will be related to efficiency of the hospital, when the newbuildings are taken into use. In other words, the efficiency in the hospital (once it is built andtaken into use) is one dimension of effectiveness of the construction.Effectiveness in the future hospital was measured and interpreted in many ways by thedifferent involved stakeholders. Future cost of operation was one aspect. Ability toaccommodate future patient volumes was another key issue. Suitable working conditions forhospital staff was yet a concern. Given the long time frame and present rate of change inhealth care, flexibility is another aspect of effectiveness in hospital buildings. Regardingflexibility, our experience is that extensive user involvement does not necessarily ensurefuture flexibility. Especially in the “locking phase” when the results from the process analysiswere converted to hard facts for decision support, the reference point to most stakeholderswas the present situation; do we get more or less than we have now; are present trends takeninto consideration?ACKNOWLEDGEMENTSThe authors want to thank Asmund Myrbostad for valuable discussions related to the paper.