Main challenges in developing trust at the institutional, organizational and interpersonal, levels in collaborative hospital construction projects according to focus group interviews
| Level of trust | Challenge | Description of the challenge |
|---|---|---|
| Organizational/interpersonal | Conflicts | Trust is tested or trust may be weakened because of mistakes, unattainable or unrealistic goals, or unsolved problems |
| Organizational | Conflicting values, objectives and interests | If alliance partners or background organizations interpret project goals differently or from their own point of view, if their goals conflict with the project's goals, or if the goals of the background organization alone guide the operations in a project, it may weaken the formation of cooperation and trust |
| Organizational | Culture of the project | Culture or team spirit may vary in projects and in subprojects; a culture of blame may exist in some subprojects; culture depends not on the contract model |
| Institutional | Different cultures of background organizations | Alliance partners work according to the processes of their own background organizations and not according to alliance processes; the culture of the project depends more on the background organizations than on people |
| Organizational | Fostering an open atmosphere | It takes time to form a culture and an open atmosphere in which people dare to state their opinions, communicate openly and bring up issues in discussion; the atmosphere may vary in projects, subprojects and teams |
| Organizational | Phase of the project | The level of trust and atmosphere may vary (get worse or better) during the project |
| Organizational | Remote working | It takes more time to form trust when not working face to face in the Big Room |
| Organizational | Unclear or unfair contract conditions | Alliance partners interpret conditions differently or there is unequal risk-sharing between contract partners, which does not encourage all the partners to work for the best for the project, potentially weakening the formation of cooperation and trust |
| Interpersonal/organizational | Problems in conflict resolution | People blame one another (this may vary in subprojects) and try to discover who is guilty instead of solving problems; difficulties are not brought up because people do not dare bring them to the conversation (if it is known that the other party's views are conflicting), resulting in unsolved problems |
| Interpersonal | Traditional habits and attitudes | Habits from traditional contract model projects may emerge in daily activities, and harmful attitudes toward people in another industry (such as toward users or designers) may complicate the development of trust. Learning a new mindset and unlearning traditional habits and attitudes takes time, and a construction site operates in a more traditional way than the Big Room, so cooperation requires more negotiation, but cultural differences and experienced differences between industries are corrected when trust and shared good experiences increase |
| Interpersonal | Weak alliance capability | It takes time to learn to work in a project alliance, such as learning to understand what is best of the project, respecting one another or not to sub-optimize (the way of acting comes from having worked in an alliance); people working in an alliance need to train the managers of their background organizations to obtain their support |
| Interpersonal | Unopen communication | People are not willing to share information (especially commercial information that could be harmful to themselves); withholding information is harmful, and difficult matters accumulate if they are not talked about |
| Level of trust | Challenge | Description of the challenge |
|---|---|---|
| Organizational/interpersonal | Conflicts | Trust is tested or trust may be weakened because of mistakes, unattainable or unrealistic goals, or unsolved problems |
| Organizational | Conflicting values, objectives and interests | If alliance partners or background organizations interpret project goals differently or from their own point of view, if their goals conflict with the project's goals, or if the goals of the background organization alone guide the operations in a project, it may weaken the formation of cooperation and trust |
| Organizational | Culture of the project | Culture or team spirit may vary in projects and in subprojects; a culture of blame may exist in some subprojects; culture depends not on the contract model |
| Institutional | Different cultures of background organizations | Alliance partners work according to the processes of their own background organizations and not according to alliance processes; the culture of the project depends more on the background organizations than on people |
| Organizational | Fostering an open atmosphere | It takes time to form a culture and an open atmosphere in which people dare to state their opinions, communicate openly and bring up issues in discussion; the atmosphere may vary in projects, subprojects and teams |
| Organizational | Phase of the project | The level of trust and atmosphere may vary (get worse or better) during the project |
| Organizational | Remote working | It takes more time to form trust when not working face to face in the Big Room |
| Organizational | Unclear or unfair contract conditions | Alliance partners interpret conditions differently or there is unequal risk-sharing between contract partners, which does not encourage all the partners to work for the best for the project, potentially weakening the formation of cooperation and trust |
| Interpersonal/organizational | Problems in conflict resolution | People blame one another (this may vary in subprojects) and try to discover who is guilty instead of solving problems; difficulties are not brought up because people do not dare bring them to the conversation (if it is known that the other party's views are conflicting), resulting in unsolved problems |
| Interpersonal | Traditional habits and attitudes | Habits from traditional contract model projects may emerge in daily activities, and harmful attitudes toward people in another industry (such as toward users or designers) may complicate the development of trust. Learning a new mindset and unlearning traditional habits and attitudes takes time, and a construction site operates in a more traditional way than the Big Room, so cooperation requires more negotiation, but cultural differences and experienced differences between industries are corrected when trust and shared good experiences increase |
| Interpersonal | Weak alliance capability | It takes time to learn to work in a project alliance, such as learning to understand what is best of the project, respecting one another or not to sub-optimize (the way of acting comes from having worked in an alliance); people working in an alliance need to train the managers of their background organizations to obtain their support |
| Interpersonal | Unopen communication | People are not willing to share information (especially commercial information that could be harmful to themselves); withholding information is harmful, and difficult matters accumulate if they are not talked about |
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