Assessment of early warning signs in hospital projects’ front-end phase

Purpose The front-end phase plays an important role in achieving project success, and establishment of performance measurement systems considering project challenges or pitfalls is a way of keeping track of this phase. Early warning signs, a type of proactive performance indicators, may serve as means for improving decision-making and project processes aiming for short- and long-term project success. In this paper, the authors present findings from a study on early warning signs (EWS) in hospital projects' front-end. A preliminary systematisation of identified signs as a contribution to front-end improvement is provided. Design/methodology/approach The paper is based on a mixed methods approach, using a sequential, exploratory research design comprising document studies, interviews and a survey. Findings The authors identified 62 challenges for hospital projects' front-end performance and further established four categories of EWS as follows: (1) structure and tools, (2) context and frame factors, (3) management and (4) relational factors and properties. This mirrors the presence of hard and soft issues from previous studies. There is need for clarifying terminology and raising consciousness on EWS. Processual approaches to identify EWS are considered more useful than subsequent established indicators. Originality/value The findings from this paper provide insight into EWS in hospital projects' front-end phase. This adds to the general understanding of EWS and contributes to more knowledge on the front-end phase in general.