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.