Proactive Risk Management in Healthcare Construction Projects

Abstract

Healthcare construction projects are characterised by high complexity, multiple stakeholders, strict operational requirements and the need to maintain ongoing healthcare services during construction activities. These conditions create significant challenges for effective risk management and increase the importance of proactive approaches that support early identification and mitigation of risks. The aim of this study was to analyse current risk management practices in healthcare construction projects and develop a proactive risk management framework adapted to the specific characteristics of healthcare environments. The study focused on public healthcare construction and renovation projects and addressed four research questions related to current risk management practices, critical risk types, factors affecting risk management effectiveness and conditions for improving proactive risk management. A qualitative research approach was adopted. The study combined a structured literature review with semi-structured interviews conducted with six professionals involved in healthcare construction projects. The empirical data were analysed using thematic analysis, allowing key patterns and themes to be identified and compared with existing theory and literature. The findings show that risk management is generally well established during the planning phase through risk workshops, risk registers and structured assessments. However, the results indicate a clear gap between planning and execution. During construction, risk management becomes more reactive, informal and heavily dependent on individual experience. Several critical risk categories were identified, including technical system risks, operational risks, coordination risks, organisational risks and scheduling risks. The findings also demonstrate that risk management effectiveness is influenced by factors such as communication, stakeholder coordination, organisational culture, governance structures and time pressure. Based on the findings, a proactive risk management framework was developed. The framework emphasises continuous monitoring, stakeholder collaboration, early risk identification, organisational learning, clear responsibilities, communication and digital support. The study concludes that improving risk management in healthcare construction projects requires not only better tools and processes but also stronger integration between project phases and a more proactive organisational culture. The study contributes to both research and practice by providing insights into how risk management can be strengthened in complex healthcare construction environments and by proposing a framework that supports proactive decision making throughout the project lifecycle.