18 project management hospital project progress case study

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Buildings Practice Facilities Plants/Petrochemicals Chapter 18 Hospital Project Progress Case Study 500 Beds ………Hospital Project-In Worst State of Construction Project Management-Case Study 1 Following statement is based purely on personal professional experience & field studies conducted on a project, which had been undergoing construction for at least pre study five years. 2 This statement should be considered only, for understanding possible management problems on projects. 3 A status report on its state of affairs is provided only, for information that this can also, happen in construction world somewhere, while identity of project is not disclosed. 4 Contractor had been informed about missing management, while it was tried to mobilize management system to some extent at that stage of critical project, but was not supported by competent authority. 5 Owner rightly believed in persons associated with them for more than 10 years then why should someone believe in a person, who just associated with organization? 6 Top manager at director level obstructed proposed improvement ways, reaching to management implementation procedures. 7 Lack of management awareness & knowledge also, came on way barricading efforts from system implementation. 8 Even then, it was tried best for many months, but could not overcome surpassing resistance from incompetent consolidation for many years. 9 Issued many site circulars & conducted coordination & control meetings, but it did not work as expected. 10 Shall try to post certain snaps also, for references, giving all types of inacceptable quality reflections. 11 Resistance to carry out work was seen at all corners due to facts that workers had been used for no work tactics for many years. Page 1 of 21 2012 Int. P Eng Suraj Singh

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Page 1: 18 project management hospital project progress case study

Buildings Practice Facilities Plants/PetrochemicalsChapter 18

Hospital Project Progress Case Study

500 Beds ………Hospital Project-In Worst State of Construction Project Management-Case Study1 Following statement is based purely on personal professional experience & field studies conducted on a project, which had

been undergoing construction for at least pre study five years. 2 This statement should be considered only, for understanding possible management problems on projects. 3 A status report on its state of affairs is provided only, for information that this can also, happen in construction world

somewhere, while identity of project is not disclosed. 4 Contractor had been informed about missing management, while it was tried to mobilize management system to some extent at

that stage of critical project, but was not supported by competent authority. 5 Owner rightly believed in persons associated with them for more than 10 years then why should someone believe in a person,

who just associated with organization? 6 Top manager at director level obstructed proposed improvement ways, reaching to management implementation procedures. 7 Lack of management awareness & knowledge also, came on way barricading efforts from system implementation. 8 Even then, it was tried best for many months, but could not overcome surpassing resistance from incompetent consolidation for

many years. 9 Issued many site circulars & conducted coordination & control meetings, but it did not work as expected. 10 Shall try to post certain snaps also, for references, giving all types of inacceptable quality reflections. 11 Resistance to carry out work was seen at all corners due to facts that workers had been used for no work tactics for many years.12 One progressive step was pulled back by two steps backwards by those people, who had determined not to do work efficiently. 13 It was not suitable to kick out nearly, full team comprising many nationalities, which state lead me to kick out self only. 14 I had faced certain threats to life also, three times during forced workers’ strikes for non payments of salaries to workers for

many months.15 Management was requested to release salaries for workers in time every month, which suggestion did not result in positive

Project Components Brief Construction Cost 100 million UDS. More than 50000 Sqm Covered Area

1 Main Building, (aluminum curtain walls & cladding envelope) 2 levels building plus basement.2 Tower 6 level plus basement, Rear area 2 storey medical operations areas plus basement, (aluminum curtain walls & cladding

envelope).3 Basement tunnel, accommodating all major services infrastructure through it.4 Supporting services as indicated below:

a CCTV system for covering all areas in buildings.

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b BMS, (building management with structured cabling system).c Fire prevention (fire alarm & smoke detection system).d Medical gas (all medical gases infrastructure).e Bed head units (all patient bed to be provided with bed head units).f Surgical panels. g Nurse call system, (all patient bed to be linked with).h OT, Isolation, CCU, ICU, Casualty, Wards. i Electrical supplies Low, Medium High & Power Voltage, Bus Bars.j HVAC supplies centralized system, based on Chilled water system as well as, package units based. k Roof of buildings utilized for generally, all HVAC system.l Earth & Lightening system provided.

Supporting components1 Services & ancillary building to accommodate standby generators & its part of tunnel operative services, pump house,

silencers to be mounted on its roof.2 Switchgear room, transformer room.3 Medical waste collection building.4 Chilled water pump room, (6 pumps each 125 hp).5 Chiller area compound, (6 machine units 250 Ton each).6 Single female building meant to accommodate nurses, (aluminum windows finishes envelope). 7 Kidney centre, (aluminum curtain walls & cladding envelope).8 Out Patient building, (cladding envelope).9 Prayer, ordinary RCC building not started yet due to being on hold.10 Guard houses, ordinary RCC building.11 SECO (electrical distribution company for electrical main supply) room, ordinary RCC building.12 External switchgear, ordinary RCC building.13 Gates in boundary walls.14 Sewage Treatment Plant, on hold yet, ordinary RCC.

External Works1 Boundary wall, precast panels.

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2 Landscape, hard & soft both,3 Underground pumping, underground water tanks, underground soft & treated water tanks4 External sewage system, including more than 100 manholes & also, few sum pits5 External fire fighting system to be installed in ring circuit or ring main.6 Street lights with more than 90 poles.

Project Status1 Project has been ongoing under construction for about 6 years.2 Structural framing had been completed long before.

What has happened during 6 years of its history?1 Initially, this hospital was designed to serve 300 beds, but later, it was upgraded to serve 500 beds successfully, by

modifications on structure & architecture considerably, meeting extended requirements.2 Contractor accepted responsibility for design modification, while client accepted contractor to modify designs, virtually, basic

construction contract converted to partly EPC. 3 Unfortunately, contractor was not capable to modify design, but messed up everything during designs & prosecution both.4 Realignment of walls & addition of floor were carried out, without conducting structural investigations.5 RCC structural framing quality has been below normal as delivered exhibiting poor standards clearly witnessed by extensive

honeycombing, bulging & out of lines alignments at various locations. 6 Majority of non structural walls were installed dry, including cement & gypsum boards fixed on metal supporting system. 7 Dry walling systems were not strong enough to sustain imposed stresses from winds & otherwise, as witnessed by warping

appearing at various locations in common, while spacing of GI backing framing did not meet stability/sustainability requirements for reasons of increased spacing pertinent various framing primary & secondary members.

8 Neither owner/client, nor consultant & nor contractor, bothered about these issues allowing this to happen, resulted in de-bonding of ceramic tiles fixed on such walls in wet areas, laboratory etc. & where, on both sides of boarding, tiles were fixed, resulted in breaking due to hammer knocking for applying corrective measures

9 All contract documents such as contract forms, contract conditions, technical specifications, bill of quantities etc. written in local language, but not English & all communications between client & contractor were made in local language as well, though English was entitled as contract communication language to an extent execution was concerned.

10 Project has generally, been managed by multinational engineers from top to bottom of hierarchy & in particular, from non English areas, who seemed not to be well educated by engineering qualification.

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11 These working engineers have zero English knowledge & surprisingly, it is really unknown, on what basis, such engineers got higher engineering degrees earned?

12 It was really work association in a different world to perform on this project, due to a fact that no professional working environment, no talking scenarios, no professional communication, no company systems, no organizational processes, no project history records were established.

13 Project was completed to an extent of 65 % when I associated & it was raised to 75 % when I demitted. 14 There was no control on more than 400 workers, while It was tried best to reinstate all workers keep busy on moving activities

among all disciplines including EME services, control services & building management requirements. 15 Contractor did not usually release salaries for 4 months for no fault of employees, while employees were not enthusiastic to

willfully/proactively work, used to slow working habits as well as, contributing to wastage of precious working hours.16 Non English site engineers & others just believed only, in telephonic talks with no official recording arrangements, while IT

being something new for them, which these personnel never intended to use.17 TQMS has been totally absent, since in fact, these people do not know about what it is, while it has been almost, impossible to

convince them pertinent introduction of a working quality management system.18 No controls on staff reporting timings due to no punctuality, exists to join shift, while many personnel await about an hour

prior to leaving shift, which means that personnel being interested only, in signing time sheet19 No procedures devised for vacations or for resignations apply within operations, evidently, every personnel has to wait for 3 to

6 weeks on an average at least, prior to proceed on leave or final exit. 20 Personnel usually waits for two months in case of resignation & at least, for one month if personnel has to avail leave vacation21 Project director had a practical requirement to survive & let many engineers/staff to survive, until next project is won for their

further deployment so as to continue employment. 22 Project was brought to such a worst state that neither it could be finished nor it could be abandoned, for both are suicidal

tendencies for contractor.23 Budget records or projections not provided by any department in organization, for no data made available for proposed

expenditure reflections, which clearly handicapped project manager about remaining balance provisions. 24 Actual cost expenses not provided by accounts, impending absence of total current expenses involved on project update.25 Payments made to subcontractors on records, not provided for further scrutiny, on subcontractors running & final

valuation/payment certifications.26 No details, not even indicative available to indicate cost to complete remaining scope of works on complete project including

maintenance. 27 No details, not even indicative are available about material quantities to be further procured to complete remaining works.

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28 Whole management is moving in doldrums, without fixed targets pertinent time, cost & resources.29 Contracting owner is not professionally qualified, while trying to carry out project to its own layman style. 30 Management can go to whatever an extent, including gratifying client representatives.31 In general, considering majority significant cases, consultants are bye passed by government officials on QA management. 32 Client engineer/s, often approve/s some material or work by direct involvements what has been rejected by consultants.33 Since, there has been operating no proper technical & other required managements procedures, more than 50 % workforce do

remain busy working on reworks, heavily augmenting budgetary cost to project. 34 Reworks add a lot on finishing items quantities wastage, involving all finishing items, such as tiling, plastering, dry lining etc. 35 Engineers are not well qualified & experienced to carry out jobs professionally, while least interested to learn activities. 36 They do not even know basis about how to coordinate with other disciplines, while just writing mails from & to vendors is

considered coordination by them, without involving detailed drawings & specification coordination in line to scope of works.37 Construction manager & other senior engineers do not know English, while coordination is remote concern/chapter for them.38 Foremen are not well qualified & experienced as many of them, do not even understand English.39 Only, certain Asian foremen are well experienced to understand given instructions & to carry out discipline activities. 40 No documents on record have been made available for every discipline, not allowing knowing history pertinent project.41 No drawing controls applied for disciplines, since status of drawings approval or rejection is unknown, while nobody knows

about drawings related works, which have been going on, whether or not, applicable drawings approved & used for prosecution implementation.

42 No system exists regarding documents controls issue ‘approved for construction’ drawings or ‘superseded’ drawings.43 Meetings are not supported by management, for project director considers meetings contributing to time wastage. 44 Directors do not know meanings of coordination/technical meetings & work output meetings.45 Intention of staff is to delay progress by whatever means possible, so as to continue for years on job, while they have too

successfully delayed project as well.46 Owner interferes on all activities, whereas one should not do so, for management does not know value of time & provision

pertinent resources to an optimum.47 Profession is operating negatively, while unforeseen risks are compounding, but fortunately, owner is sound financially.48 Consultants too are not operating professionally, since they too have been fed up on this project, but they have followed

obsolete management systems.49 Generally, finishing works are being done substandard at every location with unknown applications on quality requirements.50 Mechanical installations are getting rusted due to delay on, pre commissioning, testing, commissioning & startup. 51 Exposed pipes have rusted, while systems equipments have been lying untested for years.

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52 Integration of knowledge areas with project plan has been missing completely, for not implementing advanced management application/s.

53 No lessons are being learnt from failures, while many accidents occurred consequently, some workers got injured badly, recently someone died also

54 Reworks too, do not teach organisation a lesson, even after spending unlimited extra budget costs on such activities.55 Progress moving randomly, without any real plan to achieve target or milestone, as referred to within contract. 56 They do not understand meaning of site planning, works planning & prosecution of contract.57 Safety requirement is a remote understanding for all of them, as they neither intend to know nor understand safety nor have

any concern about SHE, evidently, no safety plan operates on project.58 Quality is not known to any of them, while they do not know about quality assurance as well as, no quality plan has been

operating on project.59 Computerisation of project for management is another world for them, while they do not realize power of IT. 60 I was surprised, when project director questioned me about why did I require computer, when I had to manage construction. 61 I was asked whether or not, I would play games on computer, to which question, I replied angrily, on his statement

consequently, he was made shut up. 62 They were very surprised on my sending E mails to them for every progress & project related information to which generally,

replied on hard copies were received & that too in local language, which had no meaning for me to act upon. 63 How to operate internet or intranet is a remote world for them, as nobody is interested to respond mails, for records are made64 All knowledge areas about Scope, Quality, Time, Cost, Risk, Human Resources, Procurement & Communication

remaining absent from project management considerations on this project.65 This is how as explained in foregoing, some projects operate in certain sectors in such countries.66 In case of resignation by employee, they deduct two months of remunerations as penalty for leaving project causing damages

to company, which deduction, they call compensation to company or organization, evidently, I also, lost my settlement sums.

Particular ReferencesDeteriorating Project Quality & Bad Performance-500 Beds ……… Hospital During Construction Stage

Salient Features of Performance1 Project running for 6 years, while progress achieved physically 75 % 2 Project Management principles applied only, to an extent 20 % indicating non existing project management, for which

clarification inputs, refer to tabulated results below, but no one is interested to improve.3 Work prosecution quality substandard in general, as no quality plan has been operating.

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4 Project not expected to complete & delivered soon due to no confirmed time management plans, no cost management & no other required project management applications

5 Employer or contractor is able to manage with client officials comfortably using one source or other

Issues of concerns1 Lead lining not provided as specified within walls of Operation Theatre rooms, which can lead to radiation leakage to patients,

medicos, other staff & general public. 2 Concrete block walls provided with thinner than specified lead lining inserted in, which is a risky detail of construction,

keeping health safety at stake.3 Main Building Tower & other buildings portions main corridor marble stone for flooring provided only 12 mm thick for

specified 20 mm thick, which contractor justifies by stating that it was delivered by mistake, but it is well understood that it is for making profits only, while government official approved this material subject to providing a thin concrete layer below during placing.

4 False ceiling suspension hangers provided too weak, consequent upon which delivery provision, many falls of suspension system have been noticed by contractor, even at work ongoing stage. a Clips of ceiling framing system are too bad in manufacturing or production. b Just imagine, had drop been affected on patients after commissioning, what would have adverse results?

5 Waterproofing applied on roofing & other wet areas do not work efficiently. a Foam concrete is allowed to exposure for many days that permits cracking on its surface.

6 Most provided dry walls are not specifically, sound in design & installation, a These are not properly aligned due to bad material & inferior construction quality.

7 Wooden doors (wet areas) lamination is not complying with specified density. a In majority of cases, consultants comments were overlooked by client engineers particularly, Eng In-charge

8 Mechanical installations were placed long back for years, which are getting corroded for example, chilled water piping, chiller equipment, chilled water pumps, Air Handling Units etc. to mention least.

9 Electrical installations are also, getting adversely effected, for installations have been waiting for commissioning for years for example, generators, silencers etc.

10 Time is being wasted on modifications & reworks in name of winning more extension of time & making more monies, while it is a professional fact that longer granted further time extension would simply mean further quality deterioration.

11 In general, contractor’s head office personnel as well as project’s personnel are too poor with professional qualifications & experience to successfully, carry out such type of specialist project.

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12 It is unfortunate that prestigious hospital project has been allowed on such low profile treatment by client professionally. 13 More than 75 engineers & more than 15 project managers have moved out of this project. 14 No records are available with contractor pertinent project history. 15 Every project manager has to step in & start anew without getting any input.16 Contractor bye passes consultants all times by getting client influence for, whatsoever problems are faced by contractor. 17 Contractor is not well equipped with capacity & potential to deliver project in defined time with successful performance of

contract.18 Project management plan effected without operation & knowledge areas integration, resulting in all delays & inefficiency on

project execution

500 Beds ………….. Hospital Being ConstructedWorking Management Status Analysis

ContractorS #

Management Factor

Points 1 2 3 4 5 6 7 8 9 10

1 SCOPE on Project Charter

5 Define Work?

HH KING

SPONSORS

BANK Contractor

Sub Contractors

Share holders

Unclear requirement

No Research

No Correction

2 QUALITY Assurance Overall

2 Structure No better

Finishes No

General Not required one

Office Records. No availability

Documents DCC. No tracks

No Lessons Learned

No Training

No Audits

No QA System

No Correction

3 TIMEContractual & Real

2 Initial OK

Extended Unclear

Rework Too many

No studies

Unknown limit

No revised plan

No recovery

No analysis

No Integration

No Updates

4 COST  ISSUEs

2 No Initial budget

No Extended budget

No Rework budget  

No studies

Expenses unknown

No real cash flow

No profits data

Risks unknown

No data

No updates

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5 RISK FACTORS

2 Contract Time loss?

Real time loss?

Price rise? Relation?

HR? Claims Issues to?

Claims issue from?

Material losses unrecorded

Insufficiency of execution

No study for anything

No Correction

6 Human Resources ISSUES

2 All Changes No Retention

High degree of Incompetency

No training arrangements

No safety arrangements

No development of staff

Salaries delays often

Frequent transfers general?

No capacity building

No efforts

No management of project

7 PROCUREMENT

2 No procedures defined

No section working

No accounting codes applied

No central management

Delays often

Accounting inefficient

No statistics

No efficiency

No policy

No consideration

8 COMMUNICATION

1 No plan

No IT Language Issues

No external links

Old system operating

No records

Only Phones

No tracking

No policy

No consideration

9  Total Quality Management evaluation out of 80 points

18                    

10 Total Quality Management Earned Evaluation

20 % Sinking Ship

Sinking Ship

Sinking Ship

Sinking Ship

Sinking Ship

Sinking Ship

Sinking Ship

Sinking Ship

Sinking Ship

Sinking Ship

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1 Above table gives an operating management plan to merely 20 % efficiency that cannot be considered right positive for a good project implementation standards

2 Except SCOPE, which operates to some extent, all areas are operating on too low profiles.3 Contractor is working in darkness & is not interested to see light of day.4 Future of project is at stake if not controlled immediately.5 Lost finances cannot be recovered, while nobody knows magnitude of losses6 Sponsor or owner has to contemplate either to close business or face high profile losses.7 Owner is encircled by non professional unqualified managers, who do not competently know their jobs, while do not have any

intention for any improvement as well.8 Overhauling of entire management profiles has to be made to survive in future.9 All management plans are required to be introduced & implemented.10 Works have been moving just like lay men often perform.11 People/personnel do not know what they are doing & what has to be done.12 No concrete direction & owners are being befooled.13 What contracting owner intends to achieve, is not clear & least bothered.14 Client is silent on inefficiency.15 Consultants are passing time without resorting to strong actions contractually.

Project management plan in operation & knowledge areas integration-brief studyProject Name –

Organisation- XYZWorking management status analysis (project level based)

S #

Management Factor

Points 1 2 3 4 5 6 7 8 9 10

1 SCOPE on Project Charter

10 Define Work

Client SPONSORS

BANK Contractor

Subcontractors

Share holders

Unclear requirement

No Research operation

No Correction

2 QUALITY 10 Struct Finish General Office Docu Lessons Training Audits QA Correctio

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Assurance Overall

ure es Records. ments DCC

Learned System

n

3 TIMEContractual & Real

10 Initial Extended

Rework Studies Unknown limit

Revised plan

Recovery

Analysis Integration

Updates

4 COST  ISSUEs

10 Initial budget

Extended budget

Rework budget  

Studies Expenses unknown

Cash flow Profits data

Risks Data Updates

5 RISK FACTORS

10 Contract Time loss

Real time loss

Price rise Relation

HR loss Claims Issues to

Claims issue from

Material losses

Insufficiency of execution

Study for anything

Correction

6 Human Resources ISSUES

10 Retention

Competency

Training arrangements

Safety arrangements

Development of staff

Salaries delays

Frequent transfers general

Capacity building

Efforts Management of project

7 PROCUREMENT

10 Procedures defined

Section working

Accounting codes applied

Central management

Delays Accounting inefficient

statistics Efficiency

Policy Consideration

8 COMMUNICATION

10 Plan IT Language Issues

External links

State of Art system operating

Records Phones Tracking

Policy Consideration

9  Total Quality Management evaluation out of 80

90                    

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10  Total Quality Management Earned Evaluation

1 Above table gives an operating management plan format that can be considered right for a good project implementation standards monitoring.

2 Except SCOPE area, all areas operating monitoring are regularly required. 3 SCOPE is generally, well defined & updated as well regularly. 4 It is to be defined well in beginning though regular update is always required whenever, is added certain effect on project charter.5 Organisation should not work in darkness & continuous monitoring must be effected.6 Future of project is to be evaluated all times during life cycle of project.7 Lost time finances, if so expected, should be conceived for making recoveries.8 Sponsor or owner has to contemplate either to promote or maintain business well or failing which, would have to face high

profile/magnitude losses.9 Owner should avoid encircling by non professional unqualified engineers/managers, who do not competently, know their jobs. 10 They should seek professional advice for business improvement as well.11 Overhauling of entire management profile has to be made as & when required to survive in future.12 All plans are required to be introduced & implemented proficiently.13 Works should move efficiently & promptly just like real professionals do perform on projects. 14 Value engineering should simultaneously, be added in almost all foregoing activities, if so efficient performance is achieved. 15 Design parts if so contracted, should also, be made/included by adding one or two rows with various design activities from FEED

to detailed drawings production stages including complete project engineering.16 People should know what they are doing & what has to be done by good communication application every now & then.17 Communication skill is considered extremely significant part on management to avoid site ongoing gossips/spreading

misinformation about schemes as well as management or groups.18 Required decisive/concrete direction & owners should be kept well informed.19 What owner intends to achieve, should be made clear by owners to management.20 Project should be considered as job that has got one start date & other completion date for successful cycle & not act as an

operation objective does. 21 Foregoing table should be filled regularly, on a monthly or a fortnightly, basis based on 10 point evaluation for each row.

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22 Then each row should be evaluated leading to total quality management row, which shall be able to declare real project management percentage.

23 Values of uniform application of evaluation coefficient can be varied, depending upon severity of importance, time & quality respecting activity.

24 Foregoing explanation simply, suggests direction for site management based on practical experience for many decades & is not related to any software programme

25 Projects are built upon millions of dollars construction investment in addition to land costs, which money belongs to society, which awaits results from all such spending

26 When, such project delivery is delayed, no anxiety or charm is left in society27 Projects are not easy to manage, but requires hard work throughout project durations28 In addition to formal time scale planning & other provisions, undisclosed planning is also, very useful depending on daily progress

achieved on site & in fact, such planning is very helpful most times.

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