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Bottlenecks and reflections from turnkey installation of MRI in a tertiary care Greenfield project: a case study
  1. Naveen R Gowda1,
  2. Nirupam Madaan1,
  3. Rahul Kumar Singh2
  1. 1 Hospital Administration, All India Institute of Medical Sciences, New Delhi, New Delhi, India
  2. 2 Civil Engg, Hospital Services Consultancy Corporation, New Delhi, New Delhi, India
  1. Correspondence to Dr Nirupam Madaan, AIIMS, New Delhi, India; Office.nirupam{at}


Background Turnkey projects are often pegged to be the solution for coordination issues and are common in procurement and installation of high-end expensive equipment. Considering the scale, cost and complexity of high-end diagnostic services like MRI, challenges during installation and commissioning have been commonly seen ever since the early days. The current case study elaborates on the lessons learnt from on-ground issues pertaining to delays in MRI installation in a Greenfield project.

Methods Root cause analysis with Ishikawa chart was done.

Results On detailed root cause analysis of the 5 broad issues, 20 causes for project delay were identified. These fall into three broad themes that can potentially affect performance of leadership.

Conclusion There are three key lessons/takeaways from the current case study. First, establishing proactive feedback loops and communication between all stakeholders. Second, the leadership should have strong control on events and milestones of the project by leveraging project management techniques and technologies. Third, unity of command and unity of direction are of paramount importance to steer the project out of doldrums. These lessons can be useful for healthcare leaders in effective project management.

  • project management
  • learning
  • analysis
  • communication
  • engagement

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  • Contributors NRG and NM conceptualised the study. NM being project officer gave inputs from project management view. RKS being the on-site project manager gave valuable inputs regarding on-ground challenges. The first draft of the manuscript was written by NRG which was reviewed and approved by the other two authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.