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Decisions regarding project definition have a significant impact on client value generation. However, although this phase is of utmost importance, traditional management practices are inadequate, as the focus is rather on budget and technical aspects leaving aside the functional ones. Neglecting the functional aspects could have serious consequences on the operation and thus quality of workspace, especially in complex projects including hospitals that involve multiple clients and with a high degree of uncertainty of change. The Lean-led Design approach provides a participative solution which involves the main project clients, namely the users (doctors, patients, etc.), project managers, and the government, with the intention of delivering facilities with a better fit for purpose and use. The main objective of the paper is to develop a framework that summarizes the steps leading to the implementation of such an approach during the project definition of a new hospital. The methodology chosen is a case study and the main contribution is to develop theoretical knowledge regarding its implementation. This may support managers in their decisions when coordinating project definitions. [ABSTRACT FROM AUTHOR]