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Project definition refers to the first three stages of a project life cycle, namely planning, programming, and preliminary design during which client needs are identified and translated into design solutions. An ill-defined hospital project definition may lead to hospital-acquired infections or patient mortality. The traditional management practices have been proved to be inadequate since architects usually do not communicate with users, and thus do not have detailed knowledge about how services are performed in the building. There is the need for more knowledge about the subject to improve and thus promote client value generation. This study first reviews factors that impact the communication between architects and clients during project definition based on the literature. The study then offers a framework based on these factors to help managers assess and improve communication between professionals and clients. The validity of the framework will then be empirically validated and revised based on findings of a longitudinal mega-hospital case study. The main objective of the current investigation is to improve the project definition practices of complex projects, and the assumption is that an effective communication provides more value to end users, as well as better project performance in terms of environmental and social sustainability.

Project definition refers to the first stages of a project life cycle (i.e. planning, programming, and preliminary design) in which client needs are identified and a conceptual design solution is developed. Defining and formalizing client needs are complex tasks especially in complex projects such as hospitals since naturally multiple clients such as managers, the government, users, clinicians, patients, and staff members among others, are involved. Each client has their own needs and interests that could sometimes be conflicting with those of the others.However, traditional methods of project definition management have been proved to be inadequate. In the traditional approach, users are rarely consulted, and the focus is more on technical issues and less on functional aspects, which impacts the future work environment and may consequently lead to increased hospital-acquired infections or patient mortality. Participative approaches such as Lean-led design, in which users including patients are involved in the process of project definition, are proposed to address this problem. However, little is discussed in the literature regarding the value of such approaches in terms of better alignment of projects with client needs.This research first identified the factors that can impact the alignment between needs and design solutions during the project definition via a systematic literature review. Based on these factors, a framework was provided to assess and improve the alignment. The validity of the framework was then empirically evaluated and revised based on a longitudinal mega-hospital case study that had implemented the Lean-led design approach the objective of which was to ensure a harmony between needs and requirements as a result of integrating two hospitals. The main assumption here is that better alignment provides more value to end users and the main contribution of this research is a framework that can help researchers and managers to assess and evaluate alignm, La définition du projet fait référence aux trois premières phases du cycle de vie du projet, soit le montage, la programmation et la conception préliminaire, où les besoins du client sont identifiés et la conception architecturale est développée. En effet, définir et formaliser les besoins des clients est une tâche difficile, surtout dans les projets complexes tels que les hôpitaux, puisque le client est multiple. Dans ces projets, le client pourrait être à la fois le gestionnaire, le gouvernement et l’usager :le clinicien, le patient, le personnel, etc. Chaque client a ses propres besoins et intérêts qui peuvent parfois être en conflit avec les intérêts des autres clients. L’approche traditionnelle utilisée lors de la définition du projet s’est avérée inappropriée. Dans ces pratiques traditionnelles, les usagers sont rarement consultés. En outre, l’accent est davantage mis sur les aspects techniques et moins sur les aspects fonctionnels. Ceci a un impact important, sur la qualité de l’aménagement, notamment l’environnement de travail ainsi que sur la santé et sécurité des cliniciens et patients. Des approches participatives telles que Lean-led Design — dans laquelle les usagers, y compris le patient, sont impliqués tout au long du processus de définition du projet — sont proposées afin de pallier ces défis. Cependant, la littérature nous informe peu sur l’impact que de telles approches ont sur l’alignement entre les besoins des clients avec la conception architecturale. Cette recherche identifie d’abord les facteurs qui influencent l’alignement entre les besoins et la conception architecturale lors de la définition du projet, sur la base d’une revue systématique de la littérature. Elle propose ensuite un cadre conceptuel établi en fonction de ces facteurs qui servira à développer et évaluer une étude de cas longitudinale d’un méga-hôpital situé au Canada. Ce projet complexe hospitalier implémente la démarche du Lean-led Design afin d’assurer l’alignement des besoin, Doctorat en Art de bâtir et urbanisme (Polytechnique), info:eu-repo/semantics/nonPublished

info:eu-repo/semantics/published

info:eu-repo/semantics/published

info:eu-repo/semantics/published