An engineering management-based investigation of owner satisfaction, quality and performance variables in health care facilities construction

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)

First Committee Member

Vincent K. Omachonu, Committee Chair


The construction industry has traditionally defined performance primarily in terms of timeliness of project completion and the ability to stay within budget. Several authors have identified a low level of quality in the design and construction processes in the U.S. and immense problems with customer satisfaction and cost effectiveness when compared with manufacturing and service industries. These problems have greatly affected a health care industry already buffeted by managed care to contain costs; consequently, the construction or renovation of Health Care Facilities (HCFs) is severely challenged. This research identifies and quantifies the gaps between the expectations and perceptions of the owners of HCF construction projects and the other main parties in construction, the designer and the builder/contractor.A nation-wide survey was conducted, targeting three groups of subjects: hospital/health care facility administrators, designers, and contractors with a declared specialization in health care related projects. This self-administered survey identified industry-based performance measures and owner satisfaction criteria in HCF projects as well as the gaps in perceptions and expectations among the parties. Nonparametric analysis of variance techniques revealed notable differences in the responses by the three groups to the same questions at the .05 level of significance. These gaps were greatest with the following variables: (a) Public and private owner satisfaction criteria, (b) performance evaluation criteria, (c) the effectiveness of quality assurance/control methods, (d) the barriers to owner satisfaction, (e) design considerations, and (f) the impact on owners caused by deviations in project schedules and costs. The gaps were greater between owners and designers than between owners and contractors with regard to design considerations and quality assurance/control approaches. With regard to performance evaluation criteria, the gaps between owners and designers are of the same order of magnitude as those between owners and contractors. These findings are especially meaningful as designers are expected to interpret owners' needs in the design process and also represent their interest in monitoring the construction phase of each project. The research also examined the gaps between public and private owners.In the third stage of the research a project-specific survey instrument was developed and administered to the three parties involved in each of a number of selected health care construction projects that had been completed within the preceding 5 years. The purpose of this survey was to apply a three-dimensional analysis to evaluate the interactions among the owner, designer, and contractor for the same project. The variables of interest were tabulated for ten (10) participating projects. A conceptual framework is developed which may be used proactively in the future to increase the likelihood of greater owner satisfaction with HCF construction projects.The research also provided a framework for the development of a national database to track the characteristics of designers and contractors with respect to a number of quality and performance variables. As data are added over time to improve the database's utility, HCF owners can use it to make informed project and provider choices that are likely to enhance their satisfaction levels and contain costs. Designers and contractors can also use it as a self-evaluation tool to improve future performance and marketability. (Abstract shortened by UMI.)


Business Administration, Management; Engineering, Civil; Engineering, Industrial

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