Project Quality Issues and Management in Royal Adelaide Hospital

This report analyzes the project quality issues of the New Royal Adelaide Hospital (RAH) project, a large-scale public-private partnership. It examines five major problems: project complexity, stakeholder influence, leadership challenges, project delays, and overseas sourced equipment. The report details the causes and effects of these issues, including sustainability concerns, stakeholder conflicts, leadership deficiencies, delays in design and construction, and problems with overseas equipment sourcing. The report also touches upon durability issues, such as door selection and electronic patient record system challenges. Key findings include the impact of government reforms, adverse environmental conditions, and the need for effective stakeholder management. The report recommends improvements in project planning, communication, and risk management to enhance project outcomes.

Running head: MANAGING PROJECT QUALITY
MANAGING PROJECT QUALITY
Name of the Student
Name of the University
Author Note:

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Table of Contents
Introduction..........................................................................................................................2
Discussion............................................................................................................................3
Defining the Problems.....................................................................................................3
Summary of each Problem...............................................................................................5
Each cause of problem.....................................................................................................8
Conclusion...........................................................................................................................9
Recommendation...............................................................................................................10
References..........................................................................................................................12

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Introduction
The following report is all about new Royal Adelaide Hospital (RAH) which is
considered to be as one of the most advanced hospital. It aims to provide full range of clinical
care to the people of Australia. The project is constructed under the public-private partnership
and SA health partnership agreement. It has been planned, constructed and financed for facilities
for competition with an exception for state fund works (Hunter, 2018). SA government was
completely responsible for various state fund works which are inclusive of core clinical parts and
utilities. At the time of the state use facility, Project co will make use of non-medical services
and maintenance. It is merely inclusive of infrastructure replacement by operating term of PPP. It
merely operates under project agreement in-between state and project which cover 35 years
expected to be ended in the year 2046. The project will cover the design and construction and
various operating phases. Any kind of delay in experience for design and construction stage will
reduce the operating phase the agreement by a term of one year (Love & Ahiaga-Dagbui, 2018).
The hospital is considered to be largest hospital in the south which is accredited teaching
hospital. It aims to provide the people of Australia with some of the best kind of outstanding
medical care. RAH has provided an international reputation which is one of finest public
teaching. The hospital aims to provide some basic training position for internal medicine,
practice, surgery and general practices. It aims to provide advanced training in the range of
speciality areas (Verzuh, 2015). The staff is merely involved in reducing the research for RAH
which is needed for medical and research.
The report helps in analyzing the key issues for this project that is RAH. The key
governance body does not have any kind of assurance on achieved progression in this particular

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project. The key risks and mitigation for RAH have been discussed in brief. There are some key
aspects like involvement of different stakeholders, lack of management measures.
Discussion
Defining the Problems
The case study merely highlights the environment in which Royal Adelaide hospital
(RAH) which comprises of stakeholder group. The stakeholder mainly comprises various bodies
of government that makes certain laws and its sansaction for the hospital construction
(McMahon, 2015). There are five major issues which are faced by this project that
Complexity of Project with respect with respect to sustainability: Complexity is mainly
encountered in this project for dealing with sustainability. It merely deals with the presence of
various strategic drivers for this new project. Initial complexity is being encountered with safety
standardization for the service users (Patanakul, 2014). The project mainly complies with the
adaptation of technology. The firm needs to follow best practices for their overall improvement.
The embracement is mainly done for the hospital park which is modified as the new designing
themes.
Controversial influence from the key stakeholders: The influence of stakeholder for
project progress is generally marked for accessing the grant to the management team of this
hospital. The stakeholder makes certain effort for managing the activities within each department
that worked separately in the same project. An issue with respect to unity is being encountered
with each of the stakeholder (Patanakul et al., 2016). The point should be noted that stakeholders
are base of any organization. The activities are discussed within the organization which are

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consulted with some of the key stakeholders. For this hospital, the key stakeholders are service
user, service providers and their family members which can supply along with the government.
Leadership Challenges for project execution: There is large number of leadership
challenges which are faced by stakeholders of New Royal Adelaide hospital (Love & Ahiaga-
Dagbui, 2018). The challenges are mainly encountered with respect to leadership activities taken
for managing the overall project. For the execution of infrastructure project, an effort is given for
providing proper maintenance infrastructure in hospital (Project Management Institute. 2017).
The overall effect of unity has made the organization very much adaptive in nature as hospital
project is related to responsibilities of leader is high. For managing these activities which are
catered in the workforces.
Delay in Project: Delay was experienced in both design and construction stage of the
project that has shortened the term phase agreement by one year. On 13 June 2017, the facilities
were handed over to the state government. The review of this project is going to be undertaken in
the reflecting stage which is being delivered to project (Rodrigues, 2018). At a result of project
delay, there was additional cost for modification, contamination and remediation that result in
increase in budget by 346.8 million dollars. In addition, the financial delay result in cost of 35.19
dollars to project coordinator which was not included in the project budget.
Overseas Sourced Equipment’s: Hospital is the place where repairs are done on urgent
basis so broken equipment’s can become as one of the major issue. Broken equipment’s in
operation theater can easily result in delay in urgent operation. In addition, broken access doors
ultimately result in issues in specific areas of the hospital (Rose, 2005). If all the equipment’s are
sourced from oversea platform, then there will be certain transport time for delivery of that

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equipment along with the effect of time zones. In addition to all this, both time zones and
language barriers can easily contribute to frustration in high pressure situation.
Durability: Defects and Delay with respect to looming safety crisis aim to effect the
electronic patient record system for paperless system. In addition, ward floors were not enough
strong to withstand the weight of paper records (Binder, 2016). Swing doors of hospital have
huge importance which is also defined as crash doors as a result of subjected punishment. There
are mainly three factors which are important for door selection of hospital like frequency of
people travelling through it, speed at which doctor, nurse staff and patient are coming through
the door and lastly way in which the door is opened (Sunindijo, 2015). The emergency
department of RAH has huge frequency, high speed in both day and night. All the doors should
have the ability to open up quickly but in addition it should be enough durable to repeat the
impact. Strain Injury is considered to be as a major issue with heavy timber doors and time of
working as a result of strain is another big problem in workplace. These particular issue can
work like roadblock for effectiveness of hospital.
Summary of each Problem
The case study of New Royal Adelaide Hospital highlights the effective attributes for
public-private partnership and they have maintained a proper arrangement. This has been done in
such a way that that it can participate and provide better support for best infrastructure. As this is
operated in the whole business venture for government partnership (Wright, & Lawlor-Wright,
2019). The private sector is required to have a necessary kind of service. Considering special
term and service the organization is able to have their stream of service. Both the internal and
external stakeholder will help in culminate the whole project in proper way (Lock, 2017). Using

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the government, the hospital can easily their management to a new level where they can get
appropriate support and protection from the government.
Doors: The overall cost of Royal Adelaide hospital is found to be around 2.3 billion
dollars which are considered to be first paperless hospital in Australia. The construction of this
building started in the year 2011. The overall construction cost has doubled that is from 244.7
million dollars to 417 million dollars. Defect and delay come up top on the looming crisis for
electronic patient records system for paperless hospital (Westover, Westover and Westover,
2010). The ward floor was not strong enough to withstand the weight of paper. Doors are
considered to be an important factor which should be taken into account at the time of hospital
construction. Coldshield Swingdoors are much lighter in comparison to solid timber doors. It is
due to the fact polymer door panels are filled up with non-CFC foam and this type of door are
used for maximum durability (Hunter, 2018). In addition, strain injury results due to use of heavy
timber doors and strain issues in workplace.
Leader issues for execution of Project: There is a large number of leadership
challenges issues encountered by stakeholder for the New Royal Adelaide Hospital. The issues
are merely encountered with respect to the leadership activities which creates a pathway for
managing overall project. There was a lack of unity among the stakeholders of the project as it
requires a strong base that makes this project much adaptive in nature (Mignone et al., 2016).
This hospital construction project has many stakeholders who are working on the same thing. So,
conflict arising in between them is considered to be as one of the major issues. It is the duty of
project manager so solve this kind of problem and have a healthy relationship with each other so
this project can be successful. There is need of managing these issues in careful way so that this
project can have better development (Wright, & Lawlor-Wright, 2019). For proper management

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of issue, project manager needs to have information so that they can solve issue by analyzing the
issue.
Using Equipment from Overseas: In hospital, there is one point where repair is required
on an urgent basis and broken equipments can become one major problem. Damaged equipment
of operation theater can easily result in delay in operation and broken access doors can result in
problem to having an access to certain areas of hospital (Sale, Page & Penniment, 2019). If all
the equipment’s of hospital are source oversea, then transport time for delivery of equipment will
be major issue. In addition to this, two other aspects that are time zone and language barrier can
result in frustration in case of high-pressure situation. The hospital should make use of products
which are manufactured on locally platform (Saunders & Carter, 2017). As the use of local
products will not only help in improving local economy but also help in reducing the cost.
Project Delay: All the current challenges in New Royal Adelaide hospital are required to
be taken into account so that project is delivered on time. The report is due to various challenges
that are being encountered for project quality issues. There are many health reforms taken by
State government which is a fundamental challenge in this project (Kerzner, 2017). This kind of
reform is completely based on state healthcare who are working in partnership. This kind of
reform tend to impact initial plan of the project which results in huge challenges. In addition,
adverse environment condition affects the overall project quality. However, adverse
environmental situation results in rescheduling of both program and operation(Meredith, Mantel
Jr & Shafer, 2017). Right from the date of technical completion and commercial acceptance
which is shifted by 76 days. This has been done so that the hospital does not open up in winter
seasons. There are many external environment aspects which focus on revising the project
budget on time. It merely requires regular communication for accommodating all the expectation

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which affect the stakeholders (Meredith, Mantel Jr & Shafer, 2017). The point can be concluded
that reforms from state government and adverse environmental condition put huge number of
challenges on project quality.
Each cause of problem
Use of Overseas materials: New Royal Adelaide Hospital has most of its equipment’s
outsource from overseas so that it can provide best treatment to its patients. If the any of the
equipment of operation is found to be damaged, then it can impact the life of a patient
(Schwalbe, 2015). In addition, if there is any broken access door then it will result in blockage to
access in some section of the hospital. There are two factors which will impact the delivery time
that is language and time zones which will create frustration in case of high-pressure situation.
The hospital should make use of locally manufactured products as the damage one will be
replaced in a minimum time interval (Heagney, 2016). For example, the hospital can make use of
Remax 4500 series high impact doors which are manufactured in Australia.
Financial Issues in Project: Financial status and management is important for research
as it identifies the certain financial issues which affect the overall quality of project. Ineffective
financial management is one of the major concern in this project. Financial managers fail to
overall cost involved in project delivery (Walker, 2015). In case of new hospital project, the
approval of ICT was lacking for a single day. In addition, there were cases, where there was
operational approval without any kind of funding. There was change in budget for this project
that is from 1.677 billion dollars to 2.094 billion dollars(Sale, Page & Penniment, 2019). In
addition to this, there was a delay in project for funding for a time period of 365 days.

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Risk management in the contract: In the Report 11 of 2018, various domains of
operation like risk management in the contract. The given report is important as it highlights
various kind of operational risk which affect the overall quality of this hospital construction
project. In the starting of the operating term, the risk registers detail of this construction project
was mentioned (Marchewka, 2016). The registered is completely designed for managing various
kind of risk of contract. In addition, there was lack of reporting from the PPP management
committee for both shared and contract risk. Also, there was delay in making reports for shared
of the government entities. Improper management of risk in any project is the biggest problem of
project quality. The local communities after addressing the service of the hospital should help of
team members so that they can solve problem in minimum time. Both suppliers and other
partners should come forward so that they can easily collaborate list of things in the given time
(Turner, 2016). It is mainly done so that management method can be easily maintained so that
they can help in serving their customer.
Conclusion
The above pages help us concluding the point that this report is about new Royal
Adelaide hospital which is considered to be as one most advanced hospital in Australia. The
hospital aims to provide a range of clinical care for the people of Australia. The project is
completed under the public private partnership (PPP). The project has been planned, design
constructed for financial facility for completing the state fund works. SA government is
completely responsible for state-funded works like clinical equipment’s and utilities. During the
use of the facility, project Co will provide the medical services and maintenance for replacing
infrastructure by operating term. PPP completely works under the project agreement in between
state and project Co for more than 35 years of time. It merely covers both construction and

10MANAGING PROJECT QUALITY
design phase of the hospital. The mere focus of this project for creating new bed facilities around
800 beds, 40 technical suites and single inpatient rooms. All the major aspect of the facilities is
completely delivered by the help of project agreement for PPP. In the year 2016, both the design
and construction phase of the project is expected to be concluded. Considering the delay in the
project, the state entered into two agreements that is settlement deed and completion deed. A
number of issues are solved under this settlement deed more specifically to contamination and
extending the technical completition. Under this deed, the state has decided to pay the project
around 69 million dollars which includes 35 million dollars for financial delay. State issued a
number of default notices which is completely under the project agreement. It merely includes
failure to have technical completition by the assigned date. In addition, there were failure to have
the best construction practices. Both competition deed and cure plan help in resolving the
growing financial risk.
Recommendation
At present, the hospital treats a large number of people in the art of environment. In
hospital, there are some leagues from the rest and new RAH is just one of them. In the
construction phase is one of the expensive building in whole Australia. The mismanagement for
this hospital construction project highlighted a clear picture about the state government for
controlling the financial loss. In addition, it focused on uncertainty and project delivery of
hospital construction. Most of the issue focused on South Australian government for fitting into
the design of the hospital. It is generally needed for fitting the main goal of the hospital for
overall efficiency. This is generally needed for proper management of workplace relation and
uncooperative environment. It ultimately results in limited accountability for the badly executed
project. A list of recommendations is discussed about the working of state government:

11MANAGING PROJECT QUALITY
 There is a need for providing greater insight about the transparency and oversight for
project life cycle. It can be achieved by providing regular status report and ongoing
performance of project. It is available to the public which includes performance and
project details.
 There is need of ensuring that internal management of the project focus on improvement
so that there can be better risk management. In addition, there should be better
contingency practices.
 In addition, there is need for better collaboration in between the department so that there
can be better practices. There is need of encouraging better decision making and
communication with the stakeholders.
 Inefficiency and any kind of unlawful influence for unions can easily increase the overall
penalties under the ABCC legislation.
 There is need of introducing guiding principles by the help of code of practices which
tender decision. It merely ensures that whole tender process is completely open and
transparent in nature.
 There are institutional penalties for various bureaucrats for contact administration which
act in unethical way. It is awarding tenders and even fails to have a high standard
diligence for competitive bid method.
By the help of above stated recommendation various aspects of the hospital project like
building cost, project in scope and delays can be prevented.

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References
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across borders. Routledge.
Heagney, J. (2016). Fundamentals of project management. Amacom.
Hunter, W. (2018). New Royal Adelaide Hospital: March 2018. Report of Auditor-General,
Government of South Australia, 33-53.
Kerzner, H. (2017). Project management: a systems approach to planning, scheduling, and
controlling. John Wiley & Sons.
Lock, D. (2017). The essentials of project management. Routledge.
Love, P. E., & Ahiaga-Dagbui, D. D. (2018). Debunking fake news in a post-truth era: The
plausible untruths of cost underestimation in transport infrastructure
projects. Transportation Research Part A: Policy and Practice, 113, 357-368.
Marchewka, J. T. (2016). Information technology project management: Providing measurable
organizational value. John Wiley & Sons.
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Auditor-General, Government of South Australia,70-73.
Meredith, J. R., Mantel Jr, S. J., & Shafer, S. M. (2017). Project management: a managerial
approach. John Wiley & Sons.
Mignone, G., Hosseini, M. R., Chileshe, N., & Arashpour, M. (2016). Enhancing collaboration in
BIM-based construction networks through organisational discontinuity theory: a case

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study of the new Royal Adelaide Hospital. Architectural Engineering and Design
Management, 12(5), 333-352.
Patanakul, P. (2014). Managing large-scale IS/IT projects in the public sector: Problems and
causes leading to poor performance. The Journal of High Technology Management
Research, 25(1), 21-35.
Patanakul, P., Kwak, Y. H., Zwikael, O., & Liu, M. (2016). What impacts the performance of
large-scale government projects? International Journal of Project Management, 34(3),
452-466.
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(pmbok guide) (Sixth ed., Pmbok guide) [Sixth edition.]. Newtown Square, PA: Project
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Rose, K. H. (2005). Project Quality Management: Why, What and How. USA: J.Ross
Publishing.Retrieved from https://ebookcentral.proquest.com/lib/ECU/detail.action?
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Sale, C., Page, D., & Penniment, M. (2019). Change management for radiation therapists–
transitioning to the new Royal Adelaide Hospital. Journal of medical radiation sciences.
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Schwalbe, K. (2015). Information technology project management. Cengage Learning.

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Sunindijo, R. Y. (2015). Project manager skills for improving project performance. International
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Iron Triangle. New York: Routledge. Retrieved from:
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