Hospitals are complex buildings and their functionality is essential for patient healthcare. Definition, verification and implementation of accurate configuration information during construction projects are therefore essential. The purpose of this study was to develop a decision support systemby establishing a value chain of configuration information with an end-to-end perspective. The approach of this study was explorative, investigating how building data can support construction projects in making hospital configuration decisions. A literature review provided a knowledge base about the configuration decision process flow, which determined the prerequisites for the proposed data and model management. Exchange and relationships of required building data were ensured by using Industry Foundation Classes (IFC) and a database model, respectively. The results show that using building model data for configuration decision support is feasible. A case study compared data exchanged in three construction projects of Magnetic Resonance Imaging rooms to those identified in the decision support system. Operational gaps regarding data exchange in the studied cases indicate what changes are required in current data collection and management. The contribution of this study is filling a research gap regarding end-to-end information management to support hospitalconfiguration decisions in construction projects.

The purpose of hospital buildings is to enable the diagnosis, treatment and caring of patients. Hospital configurations are therefore complex and deficient functionality at the final delivery of construction projects are a known issue. Configuration management is essential to ensure that all required functions are fulfilled. Digital building model data can provide the necessary information to support management of hospital configurations. Data based decisions are dependent on a baseline that contains all required functions. Thereafter, connections between data regarding functions, solutions and production methods should be established. This knowledge provides opportunities for automated data analyses giving real time accurate configuration information, enabling the prevention of deviations from the client’s intent and streamlining processes. The studies in this compilation thesis investigate this subject from different perspectives. Literature reviews, case studies and quantitative analyses of digital building data were the methods used. The results show that the systematic management of data and information can ensure hospital configurations that fulfil required functions at handover. These studies provide a conceptual model showing how configuration information applies to the construction project processes. The proposed detailed decision model shows how data from building models can support hospital configuration decisions in construction projects. Studies show that hospital construction projects management of configuration changes information is deficient. Manually managed logs contained insufficient information about the changes, while the building model data unused by the investigated projects was significantly more reliable. A risk analysis shows that data based configuration decisions in construction projects can prevent hospital building deficiencies, or facilitate recovery if they have already occurred. Digital technologies can improve the accuracy of configuration information, on which automated and industrial production equipment are dependent. However, construction project research seldom addresses the potential synergy and sustainability effects of different technologies. All case studies performed show that the current configuration information management in hospital projects is incomplete. Consequences found were cost increase, delays, reduced client value and corrective rework. The overall conclusion is that data based decisions can improve the control over hospital configurations, ensuring healthcare functions, construction project outcomes and sustainability. This thesis identifies a new research field by showing the potential of data based configuration decisions.

Syftet med sjukhusbyggnader är att möjliggöra diagnostisering, behandling och vård av patienter. Komplexiteten i utformningen av sjukhus gör att bristande funktionalitet är ett känt problem vid slutleveransen i byggprojekt. Därför är styrningen av utformningen viktig för att säkerställa att alla erforderliga sjukvårdsfunktioner uppfylls. Digitala byggnadsmodeller kan tillhandahålla data som ger information som stödjer styrningen av sjukhusutformningar. Databaserade beslut kräver en tydligt definierad basutformning innehållande alla funktionskrav. Därefter behöver datasamband mellan funktioner, projekteringslösningar och produktionsmetoder fastställas. Denna kunskap ger möjlighet till automatiserade analyser som ger information om utformningen i realtid, vilket förebygger avvikelser från kundens intentioner och effektiviserar processer. Studierna i denna sammanläggnings-avhandling undersöker detta ämne med olika perspektiv. Litteratursammanställningar, fallstudier och kvantitativa analyser var metoderna som användes. Resultaten visar att systematisk hantering av data och information gällande sjukhusutformningar möjliggör säkerställande av att funktionskrav uppfylls. Studierna tillhandahåller en konceptuell modell som visar hur utformningsinformation kan användas i byggprojektprocesserna. En detaljerad beslutsmodell visar hur byggnadsdata kan förse sjukhusprojekt med utformningsbeslutsstöd. Undersökningar av hur information gällande utformnings-ändringar hanterades i sjukhusbyggprojekt visade på brister. Manuellt hanterade loggar innehöll bristfällig information gällande ändringar, medan de av projekten oanvända byggnadsmodelldata signifikant hade förbättrat tillförlitligheten. En riskanalys visar att databaserade beslut kan förebygga utformningsbrister i sjukhusprojekt och underlätta en återställning om de uppkommit. Automatiserande industriella produktionstekniker är beroende av tillgång till tillförlitlig av utformningsinformation. Resultaten visar att potentiella synergi- och hållbarhetseffekter av olika teknologier sällan adresseras inom byggprojektforskning. Alla fallstudier som gjorts visar att nuvarande hantering av utformningsinformation är ofullständig. De konsekvenserna som hittats är kostnadsökningar, förseningar, minskat kundvärde och korrigerande omarbetningar. Den övergripande slutsatsen är att databaserade beslut kan öka kontrollen över sjukhusutformningar, vilket säkerställer sjukvårdsfunktioner, byggprojektutfall och hållbarhet. Denna avhandling identifierar ett nytt forskningsområde genom att påvisa potentialen i databaserade utformningsbeslut.

Hospitals are complex buildings and design solutions should fulfil functionalities to enable accurate diagnosis, treatment, and care. However, scientific results are seldom the basis for the design solution choices. Magnetic resonance imaging facilities require concrete structures fulfilling high requirements on vibration isolation to ensure diagnostic accuracy. The aim of the studies was to compare evidence from the literature to the chosen solutions in eight newly designed magnetic resonance imaging facilities. The conclusions are that there is insufficient scientific evidence for which structural configurations fulfil vibration requirements of MRI facilities, while those found were only partially implemented in recent designs.

Traditionally, the evaluation of changes in construction projects focuses on implications for cost and time. Analysis of impact on the configuration and subsequent end-user functionality is less analysed. Healthcare constructions have complex configurations and the functionality is imperative for patient care. There are problems with the deliveries in healthcare construction projects not fulfilling end-user functionality. Control of configuration changes reduces the risk for deviations from intended functionality. This study establishes the information required to obtain control and the availability in healthcare construction projects. A framework based on a literature review describes the information that is required to control configuration changes. In a case study of thirteen healthcare reconstruction projects, the available informationabout changes was compared with the framework. Management of changes was deficient in all the cases. In the investigated project logs, the implications of the configuration changes were significantly underestimated. Object models data provided detailed information about the impact of changes on the configuration, but this possibility was not used. There was no available information about requests to change the configuration, consequence analyses or implementation decisions. This study fills a research gap by adding the configuration perspective to change management in construction projects.

The configuration of healthcare buildings is complex, especially emergency hospitals that require many functions. In this study, the aim was to explore if automated configuration control can reduce occurrences of hospital deficiencies in construction projects. A bow-tie risk analysis identified the causes and consequences of configuration deficiencies. Measures to prevent and recover from deficiencies were established from configuration management research. Three newly built emergency hospitals were studied to investigate to what extent causes, consequences, preventive and recovery measures were present. The most common causes of deficiencies were deviations from intended configurations, in the literature and the cases. The consequences were cost increase, time delays, insufficient deliveries and corrective rework. None of the examined cases had implemented preventive or recovery measures associated with configuration control. Altogether, these results indicate that automation of configuration control may effectively reduce hospital building deficiencies and subsequent effects.

The development towards a fourth industrial revolution requires a transformation of industries and integration of technologies. Industry 4.0 was developed to investigate the implications of new technologies in manufacture and production corporations. Construction 4.0 is the corresponding initiative for the architecture, engineering, construction and operation industry. The purpose of this study was to compare papers that address the two concepts to find possible areas of research collaborations and opportunities for knowledge transfer. A literature review was performed of journal papers from 2020 to investigate the current application of Industry and Construction 4.0 in research. The results show several similarities between Industry and Construction 4.0 regarding data and information handling and the need to transform industries. Industry 4.0 had a focus on management and integration of technologies that can create value through entire processes. Construction 4.0 was oriented towards discovering solutions to bridge between different actors participating in a sequential process. The results identify possibilities for interdisciplinary collaborations, knowledge exchange and areas for joint explorations between the two research disciplines.

The architecture, engineering and construction industry focus on the project rather than on the product management. However, the development of digital and automated techniques requires more product based processes. Configuration information is an essential part of product management to ensure high performance. This study aims to explore if systematic configuration information, used in product development, can be applied in construction projects. An international guideline and an extensive literature study identified five key areas of configuration information applicable to construction projects. This knowledge was synthesised into a conceptual model for managing configuration information. A survey investigated the application of configuration information in construction projects. In comparison with the model, the results from the literature review and the survey show that configuration information was insufficient and not managed systematically. However, the findings also indicate that systematic configuration information can be used to improve control over the product and solve several problems encountered by construction projects. This study fills a knowledge gap regarding the management of configuration information in the context of construction projects. The ongoing development of new technologies in the architecture, engineering and construction industry will make the subject of configuration information increasingly important.

The development of technologies associated with the fourth industrial revolution is rapid. Construction 4.0 represents the architecture, engineering, construction and operations industries exploration of new technologies, equivalent to Industry 4.0 for the manufacturing industry. These concepts address multiple perspectives besides the technological, such as management and processes. The purpose of this study was to investigate to what extent research regarding construction projects addresses information and communication, automatisation or industrialisation technologies. A scoping review was the method used to perform a quantitative analysis of over two thousand journal papers published from 2015 onwards. The results show that new technologies are addressed separately, while synergy studies are uncommon. Longitudinal analyses show that there was no significant increase in journal papers concerning new technologies from 2015 to 2019. Information and communication was the search criterion with the least number of papers found. The environmental perspective of new technologies was present but the least common from 2019 to 2020. Hence, this review shows that there is an extensive research gap regarding Construction 4.0 technologies in the context of construction projects. Studies regarding synergy and environmental effects of new technologies should increase to start the progress towards a successful entry into the fourth industrial revolution.

The transfer of information between the different phases of construction projects is limited, which complicates the quality assurance of configurations. Functional requirements on the building configuration are often ambiguous and lack measurable acceptance criteria. Vaguely described criteria provide an insufficient basis for the design and verification acceptance values. The contractor is often the first to consider the feasibility just before or during the production phase. However, feasibility including production methods should be considered with the establishment of each design solutions. Costs or time consequences are often the basis for change decisions, while the investigations of the impact on the building configuration and functionality are insufficient. A continuous flow of information with functional requirements as a controlling factor is required to control configurations. Functionality that ensure high quality patient care are essential in health care facilities, therefore the control of the configurations are particularly important.

This licentiate thesis shows how configuration information in healthcare construction projects can ensure necessary building functionality. The following information areas are identified as necessary for control of configurations: function, verification, design solution, production and change control. All information is related and changes in one area affect the others, directly or indirectly during construction projects. The studies that are the basis of this licentiate thesis show that the management of configuration information was deficient in healthcare construction projects, especially regarding availability and interconnectivity. In addition, the information was not available at the right time during the construction process, which impaired configuration control. For example, verification methods were not available until the end of production. This precluded verification of intended functionality through large parts of the construction project. Detailed change information from digital models of buildings can significantly improve control of configurations, but this requires standardisation of input data.

In the manufacturing industry, configuration management is practised to ensure that products fulfil the required functions throughout their entire lifecycle. Development of new technologies, such as digital processes and industrialised construction, require that construction projects develop working processes similar to those of the manufacturing industry. The risk of unnecessary rework with subsequent cost increases, delays and environmental impact decrease with increased control of the configuration. In construction projects, systematic management of configuration information can ensure delivery of healthcare facilities with intended functionality.

Överföringen av information mellan de olika faserna i byggprojekt är ofta begränsad, vilket försvårar kvalitetssäkring av utformningen. De funktionella kraven på byggnadens utformning är ofta tvetydiga och saknar mätbara acceptanskriterier. Det ger en otillräcklig grund för projekteringslösningarnas och verifieringsmetodernas acceptansvärden. Möjligheten att färdigställa en utformning övervägs ofta av entreprenören precis före eller under produktionsfasen, men bör säkerställas för varje projekteringslösning. Beslut gällande ändringar baseras ofta på kostnads- eller tidskonsekvenser, medan utredningar av hur byggnaders utformning och påverkas är otillräcklig. Ett kontinuerligt informationsflöde med funktionella krav som styrande faktor krävs för att kontrollera utformning. Kvaliteten på patientvården måste säkerställas i vårdbyggnader, därför blir kontroll av utformningen är särskilt viktig.

Denna licentiatuppsats visar hur utformningsinformation i vårdbyggnadsprojekt kan säkerställa anläggningens funktionalitet. Följande informationsområden identifieras som nödvändiga för kontroll av utformningen: funktion, verifiering, designlösning, produktion och ändringskontroll. Information gällande utformningen av en byggnadsdel är relaterad och ändringar inom ett område påverkar de andra, direkt eller indirekt under ett byggprojekt. Studierna som ligger till grund för denna licentiatuppsats visar att det finns brister inom alla områden av utformningsinformation, speciellt gällande tillgänglighet och sammankoppling. Kontroll av utformningen försvårades dessutom av att informationen inte var tillgänglig vid rätt tidpunkt under byggprocessen. Verifieringsmetoder fanns till exempel inte tillgängliga förrän i slutet av produktionen. Det försvårar säkerställandet av avsedda utformning genom stora delar av projektet. Detaljerad information från digitala byggnadsmodeller kan förbättra kontrollen av vårdbyggnaders utformning, men det kräver standardisering av indata.

Tillverkningsindustrin utövar konfigurationsledning för att säkerställa att produkters utformning motsvarar kravställda funktioner genom hela deras livscykel. Utvecklingen av nya tekniker, såsom digitala processer och industriell produktion, kräver att byggprojekt utvecklar arbetsprocesser som liknar de i tillverkningsindustrin. Risken för onödiga omarbetningar med efterföljande kostnadsökningar, förseningar och miljöpåverkan minskar med ökad utformningskontroll. Systematisk hantering av utformningsinformation i vårdbyggnadsprojekt kan säkerställa att leveransen uppfyller avsedd funktionalitet.

Requirements management in construction projects have a tendency towards production-driven processes and definition of technical solutions. The stakeholders are involved by being asked to comment on defined products which can have consequences on the performance of the end-product. This comparison describes three projects within the Stockholm County where the scope to build new medical imaging facilities with the same requirements on the concrete floor structure. The result shows that the same requirements have resulted in different solutions which could have an impact on the performance of the buildings. Further research regarding tools for systematic requirements management is needed to ensure performance and sustainability of new buildings.