Design and procurement integration strategies in construction projects play an important role and have an impact on the overall project cycle. Integrated design and procurement will increase productivity and reduce waste. This research aims to provide a guide to good design and procurement integration strategies in Design and Build (DB) projects in government projects. This research uses qualitative and quantitative methods in the form of a schematic literature review followed by a Focus Group Discussion (FGD) with the Delphi method to formulate integrated design and procurement that improve project performance. In-depth interviews were conducted with 90 respondents to explore the implementation of the design and procurement strategy on the project used as a case study. The results of this research are recommendations for an integrated design and procurement strategy which can be used as a Standard Operating Procedure (SOP) in DB projects on government projects so that it can provide added value from the start of the project being designed through tenders. This research can be utilized by project stakeholders, academics and anyone who will develop project performance through the integrated design and procurement in the long term.

While there has been much discussion about the large infrastructure needs in Asia and the Pacific, less attention has been paid to public expenditure efficiency in infrastructure services delivery. New constructions are not the only solution, especially when governments have limited capital to invest. Globally, new infrastructure projects face delays and cost overruns, leading to an inefficient use of public resources. The root causes include the lack of transparency in project selection, the lack of project preparation, the silo approach by public entities in assessing feasibility studies, and the lack of public sector capacity to fully develop a bankable pipeline of projects. To tackle these issues, governments need a smarter investment approach and to do so, enhancing public service efficiency is very crucial. The paper suggests a “whole life cycle” (WLC) approach as the main strategic solution for the discussed issues and challenges. We expand the definition of WLC to include the entire life cycle of the infrastructure asset from need identification to its disposal. The stages comprise planning, preparation, procurement, design, construction, operation and maintenance, and disposal. This is because we believe any efficient or inefficient decision throughout such a wide life cycle influences the quality of public services. Hence, in this holistic approach, infrastructure life cycle consists of four phases: planning, preparation, procurement, and implementation. Governments could enhance public efficiency and thus improve access to finance throughout the WLC by several solutions. These are (i) preparing infrastructure master plan and pipelines and long-term budgeting during the planning phase; (ii) establishing framework and guidelines and improving governance during preparation phase; (iii) promoting standardization, transparency, open government, and contractual consistency during the procurement phase; and finally (iv) continued role of government and total asset management during the implementation phase. In addition to these phase-specific means, key WLC solutions include proper use of technology, capacity building, and private participation in general and public-private partnership (PPP) in particular.

Introduction: In Central Europe, in Hungary, the state guarantees access to health care and basic health services partly through the Semmelweis Plan adopted in 2011. The primary objectives of the Semmelweis Plan include the optimisation and transformation of the health care system, starting with the integration of hospitals and the state control of previously municipally owned hospitals. The transformation of the health care system can have an impact on health services and thus on meeting the needs of the population. In addition to reducing health inequalities and costs, the relevant benefits include improving patients’ chances of recovery and increasing patient safety. The speciality under study is decubitus care. Our hypothesis is that integration will improve the chances of recovery for decubitus patients through access to smart dressings to promote patient safety. Objective: to investigate and demonstrate the effectiveness of integration in improving the chances of recovery for decubitus ulcer patients. Material and methods: The research compared two time periods in the municipality of Kalocsa, Bács-Kiskun County, Southern Hungary. We collected the number of decubitus patients arriving and leaving the hospital from the nursing records and compared the pre-integration period when decubitus patients were provided with conventional dressings (01.01.2006–2012.12.31) and the post-integration period, which entailed the introduction of smart dressings in decubitus care (01.01.2013–2012.12.31). The target population of the study was men and women aged 0–99 years who had developed some degree of decubitus. The sample size of the study was 4456. Independent samples t-test, Chow test and linear trend statistics were used to evaluate the results. Based on the empirical evidence, a SWOT analysis was conducted to further examine the effectiveness of integration. Results: The independent samples t-test model used was significant (for Phase I: t (166) = −16.872, p < 0.001; for Phase II: t (166) = −19.928, p < 0.001; for Phase III: t (166) = −19.928, p < 0.001; for Phase III: t (166) = −16.872, p < 0.001). For stage III: t (166) = −10.078, p < 0.001; for stage IV: t (166) = −10.078, p < 0.001; for stage III: t (166) = −10.078, p < 0.001). for stage III: t (166) = −14.066, p < 0.001). For the Chow test, the p-values were highly significant, indicating a structural break. Although the explanatory power of the regression models was variable (R-squared values ranged from 0.007 to 0.617), they generally supported the change in patient dynamics after integration. Both statistical analyses and SWOT analysis supported our hypothesis and showed that integration through access to smart dressings improves patients’ chances of recovery. Conclusions: Although only one segment of the evidence on the effectiveness of hospital integration was examined in this study, integration in the study area had a positive impact on the effective care of patients with decubitus ulcers, reduced inequalities in care and supported patient safety. In the context of the results obtained, these trends may reflect different systemic changes in patient management strategies in addition to efficient allocation of resources and quality of care.

Delay is the leading challenge in completing Engineering, Procurement, and Construction (EPC) projects. Delay can cause excess costs, which reduces company profits. The relationship between subcontractors and the main contractor is a critical factor that can support the success of an EPC project. The problematic financial condition of the main contractor can cause delay in payments to subcontractors. This research will set a model that combines the system dynamics and earned value method to describe the impact of subcontractor advance payments on project performance. The system dynamics method is used to model and analyze the impact of interactions between variables affecting project performance, while the earned value method is applied to quantitatively evaluate project performance and forecast schedule and cost outcomes. These two methods are used complementarily to achieve a holistic understanding of project dynamics and to optimize decision-making. The designed model selects the optimum scenario for project time and costs. The developed model comprises project performance, costs, cash flow, and performance forecasting sub-models. The novelty in this research is a new model for optimizing project implementation time and costs, adding payment rate variables to subcontractors and subcontractor performance rates. The designed model can provide additional information to assist project managers in making decisions.

It is possible to provide green, ecological, and innovative products and services through green and sustainable public procurement. This study analyzes the opportunity offered to public contracting authorities in the Republic of Croatia (RH) in transformation from existing economy to a sustainable one through the inclusion of small and medium sized (SME) companies and inclusion of selection criteria that promote all three sustainable goals. The study employed a qualitative method and empirical analysis of public procurement procedures for eggs in the period from 2013 to 2021 in RH. The product was procured in many social institutions, hospitals, schools, student canteens and by procuring a sustainable product, added value could be created for the entire community. Data from the Electronic Public Procurement Classifieds of the Republic of Croatia (EOJN RH) and Data from the State and European Union (EU) Statistical Office were used. The research showed that sustainable procurement criteria were used for the first time in 2021, and that public contracting authorities put a stronger focus on the environmental pillar of sustainability and less or almost none on the economic and social pillar. The volume of demand and production was also calculated. The study found that the first contractor for sustainable product was SME company, producer of food, who adapted to the green conditions of public procurement in a short period of time. The paper empirically demonstrated that public procurement can be a powerful tool, but it was not used enough in the observed period for the observed products in RH.