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Purpose Digital practices of facility management (FM) are undergoing transformation. Several Nordic countries have ambitious hospital-building projects, driven by large public clients with long-term experience of operating complex building campuses. There is thus an opportunity for creating state-of-the-art digital FM. This paper aims to investigate the role of digital FM in new hospital projects in Scandinavia. Design/methodology/approach Based on a literature review, a framework of understanding of digital FM in hospital operation is established. Two longitudinal cases are presented and analysed, one for a greenfield hospital and the other for an extension of an existing hospital. Findings The literature highlights the importance of integration between technical digitalization, competences, organization and management of digital FM. The projects are in different phases and represent quite advanced preparations for digital FM. State-of-the-art computer-aided FM systems are prepared before operation. External consultants are involved, posing a dilemma of in-house/outsourced human resources in the future digital FM operation. Research limitations/implications Two case studies provide insights, but they have limited generalizability. Practical implications The study underscores the importance of preparation of management, organization and competences for digitalization. Originality/value Documented research on building information modelling (BIM) integrations in FM is still scarce. This article adds to the few empirical studies in the area. The findings illustrate that real estate administrators investing in FM software for new hospital buildings face challenges of aligning BIM models from design and construction to the FM system.

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This article elaborates on lean thinking in design management. Lean philosophy focuses on minimizing waste and maximizing value. We discuss how lean concepts can be understood and how this can affect the design process. In particular, we examine how flexibility can be achieved through the use of a layered design process and a layered building design. The design process has two main outcomes: input to the production and/or construction process, and input to the decision process. These two outcomes have a number of contradictory characteristics. Traditionally, production processes call for early decisions and control of cost, time and risks. Typically, this has been the engineers' or the contractors' perspective. In contrast, the decision process typically strives to postpone final commitments and design freeze in order to keep options open. Lean thinking shows that the two approaches do not have to be contradictory. Based on case studies of two hospital projects, we discuss flexibility in the design process and design in relation to lean principles. The article demonstrates the importance of seeing the design process and design model as two integrated parts. Lean thinking can serve as an enabler by focusing on reducing waste and increasing the customer's value.

The aim of the article is to explore use of, and challenges associated with, spatial change management strategies. This is done through a discussion on how spatial environments may be utilised to effect organisational change. The intention is to provoke new thinking on physical change initiatives and to challenge the often highly deterministic view regarding effects of contemporary workspace concepts. Design/methodology/approach: The article is structured as a case study based literature review, drawing on literature from the fields of environmental psychology, organisational branding, corporate real estate and facility management-as well as organisational change management. Findings: The study indicates that space management strategies may fail due to lack of understanding of how organisational events and other contextually specific aspects correlate with the physical change initiative. Succeeding with the spatial strategy therefore requires a strong focus on socio-material relationships and employee meaning making process during the spatial change process. Originality/value: Contrary to the traditional and rational focus on functional space management strategies, the article takes a socio-material approach suggesting that there is a need for more empirically based research into the meaning making process and the role of human and organisational practices in the construction of new workplace concepts. Focusing on how organisational members understand and 'make use of' spatial environments may substantially improve organisations' and building consultants' abilities to strategically manage the physical change initiative and achieve the intended ends.