Causes of Rework in California Hospital Design and Permitting: Augmenting an Existing Taxonomy

Peter P. Feng1 & Iris D. Tommelein2

1Assistant Professor, Engineering Management Department Air Force Institute of Technology, Dayton, OH 45431, Phone +1 510/292-9786, [email protected]
2Director, Project Production Systems Laboratory ( and Professor, Civil and Environmental Engineering Department, 215-A McLaughlin Hall, University of California, Berkeley, CA 94720-1712, Phone +1 510/643-8678, FAX +1 510/643-8919, [email protected]


Based on the premise that healthcare facility design and construction costs are escalating due to rework in (1) upfront planning, (2) programming, (3) design, and (4) permitting phases, a group of healthcare facility owners, architects, designers, contractors and state permitting personnel conducted a study to understand where the waste occurs. This study identified 158 process waste items. In this paper we categorize these 158 waste items using an existing taxonomy of rework and extending it as needed. The existing taxonomy of rework contains five categories: (1) human resource capability, (2) leadership and communication, (3) engineering and reviews, (4) construction, planning, and scheduling, and (5) material and equipment supply. The extension places waste items into three new categories: (1) planning, programming, and budgeting, (2) design planning and scheduling, and (3) design review. This research identifies what causes of rework are within the California healthcare facility design and permitting phases. Understanding these waste items provides a foundation on which to build new practices that avoid costly design and permitting delays.


Cause and effect diagram, design and permitting, rework, and lean construction.



Feng, P. P. & Tommelein, I. D. 2009. Causes of Rework in California Hospital Design and Permitting: Augmenting an Existing Taxonomy, 17th Annual Conference of the International Group for Lean Construction , 407-416.

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