Assessing the Impact of Functional Changes on Building Systems Integration and Construction Management in Hospital Projects: A Case Study

Abstract

Hospital construction projects are highly complex and frequently experience functional changes during the construction phase due to evolving healthcare service requirements and operational standards. These changes can significantly influence technical building systems and construction management practices. This study aims to evaluate the impacts of functional building changes on structural, architectural, mechanical, electrical, and plumbing (MEP) systems, as well as on construction management in a hospital project. A descriptive–analytical case study approach was employed using secondary data derived from project documentation, including contract addenda, bill of quantities, technical justification reports, and chronological adjustment records. The analysis involved identifying functional changes and classifying their impacts across technical and managerial dimensions. The results indicate that functional changes, such as increased patient capacity, relocation of key facilities, and expansion of utility systems, lead to substantial cross-disciplinary adjustments. These include increased structural loads requiring design modifications, reconfiguration of architectural layouts, expansion of MEP system capacities, and significant changes in project scope, cost, and scheduling. Furthermore, such changes intensify coordination requirements among stakeholders and necessitate adaptive management strategies. The study concludes that functional changes should be considered strategic drivers that influence both engineering decision-making and construction management performance. Therefore, an integrated and coordinated approach to change management is essential to maintain system performance, ensure project continuity, and effectively respond to evolving functional demands in hospital construction projects.