医院工程变更管理案例分析

发布时间：2018-11-11 10:56

【摘要】：近年来,随着我国医疗事业的改革逐渐深入,为了满足人民群众的医疗需求,为了改变现状不平衡的医疗资源,全社会对医院建筑的需求越来越大,很多医院建设工程项目应运而生。随着这些项目的实施,大家逐渐发现这些医院工程建设存在许多问题,如进展缓慢,工期延误;成本失控,超概严重;医疗使用功能未实现;参建人员发生违规违纪的现象。种种情况说明现状的医院工程项目管理还存在较大的问题,而这些问题的直接原因就是工程变更太多。医院工程建设区别于其他民用建筑,有复杂、专业多、要求高、影响大等特点。同样,医院工程的项目管理也有自身的特点,管理难度大,协调多、标准高等。由于目前我国医院工程的项目管理仍存在管理经费少,管理人员短缺,专业能力不足,制度不健全等问题,导致医院工程的项目管理还比较混乱,实际效果不理想。文中以某保健基地项目为主,某门急诊楼项目为辅,对医院建设过程中发生的变更管理案例进行了整理、归纳、分析和研究,通过统计分析和与业内相关的专家及从业人员进行访谈交流,得出变更发生的主要原因及主要专业,找出变更的高发区域以及对造价影响最明显的变更种类,为变更管理特别是变更预控指引方向。同时通过有针对性地选择十五个具体变更案例,对其管理过程及结果进行了分析。通过这些案例以及对整个项目变更管理进行的后评估,总结变更管理的得与失。后评估分别从四个方面开展:设计管理、施工管理、监理管理以及业主协调。前面三个主要是体现工程管理中的设计、施工、监理的三条主线。特别加上业主协调,是针对医院项目管理中业主的意识对项目的影响太大,能否做好业主的沟通协调工作是最后项目管理成败的关键。最后通过案例的分析以及后评估,找到一些成功的变更管理办法和有效的变更管理措施。为今后医院工程的变更管理提供一些借鉴和参考。
[Abstract]:In recent years, with the deepening of medical reform in our country, in order to meet the medical needs of the people and to change the unbalanced medical resources, the whole society needs more and more hospital buildings. Many hospital construction projects came into being. With the implementation of these projects, it is gradually found that there are many problems in the construction of these hospital projects, such as slow progress, delay of construction period, out-of-control cost, serious overrun, unrealized function of medical use, and the phenomenon of violation of rules and regulations by participants. The situation shows that there are still some problems in hospital project management, and the direct cause of these problems is too many engineering changes. Hospital engineering construction is different from other civil buildings. It is complex, professional, demanding and influential. Similarly, the project management of hospital engineering also has its own characteristics, the management is difficult, the coordination is much, the standard is high. At present, there are still some problems in the project management of hospital engineering in our country, such as the shortage of management funds, the shortage of management personnel, the insufficiency of professional ability and the unsound system, which leads to the confusion of project management of hospital engineering, and the actual effect is not ideal. Based on a health base project and an emergency building project, this paper collates, summarizes, analyzes and studies the case of change management in the course of hospital construction. Through statistical analysis and interviews with relevant experts and practitioners in the industry, the main reasons for the change and the major specialties are obtained, and the areas of high incidence of changes and the types of changes that have the most obvious impact on the cost are found. Guide the direction of change management, especially change control. At the same time, the management process and results are analyzed by selecting 15 specific change cases. Through these cases and the post-evaluation of change management of the whole project, the gains and losses of change management are summarized. Post-evaluation is carried out from four aspects: design management, construction management, supervision management and owner coordination. The first three are the three main lines of design, construction and supervision in engineering management. Especially, the owner coordination is the key to the success or failure of the final project management, because the consciousness of the owner has too much influence on the project, and the communication and coordination of the owner is the key to the success or failure of the final project management. Finally, through case analysis and post-evaluation, we find some successful change management methods and effective change management measures. To provide some reference and reference for the change management of hospital engineering in the future.
【学位授予单位】：清华大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R197.38

【参考文献】