Project Management Office (PMO) Establishment for a Multi-Asset Hospital Construction Programme in Saudi Arabia's Healthcare Sector

A Saudi healthcare development organisation responsible for delivering a multi-asset hospital construction programme comprising several new hospitals and specialist facilities across multiple regions, with a combined capital value exceeding SAR 6 billion and aligned with Vision 2030's Health Sector Transformation Program. Facing schedule slippage, cost overruns, and fragmented oversight across its delivery partners, the organisation engaged Saudi Strategy Advisory to establish a programme management office capable of restoring control and delivery certainty.

• Fragmented Programme Oversight: The programme was being delivered through multiple contractors, consultants, and internal teams with no unified governance, reporting, or control framework. Leadership lacked a single, reliable view of programme status, cost, and risk across the asset portfolio.
• Schedule Slippage & Cost Overruns: Several assets were experiencing schedule delays and budget overruns that were being identified too late for effective intervention, threatening the programme's overall delivery timeline and budget envelope.
• Inconsistent Controls & Reporting: Cost, schedule, risk, and change-control processes varied between assets and partners, producing inconsistent and non-comparable reporting that prevented leadership from prioritising attention and resources effectively.
• Weak Risk & Interface Management: Interdependencies and interfaces between design, construction, equipment procurement, and commissioning were poorly managed, generating clashes, rework, and delay that a coordinated programme function could have prevented.
• Limited Decision Support: Leadership lacked the structured data, forecasting, and escalation mechanisms required to make timely, well-informed decisions on issues affecting cost, schedule, and clinical readiness across the programme.

Saudi Strategy Advisory was engaged to establish a programme Project Management Office — providing the organisation with a unified governance and controls framework, integrated reporting, proactive risk and interface management, and the decision-support capability required to restore delivery certainty across the multi-asset hospital programme.

• PMO Design & Governance Framework: Designed the PMO operating model, governance structure, decision rights, and meeting and escalation cadence, establishing clear accountability between the organisation, contractors, and consultants across the asset portfolio.
• Integrated Controls Implementation: Implemented standardised cost, schedule, risk, change, and document-control processes across all assets, creating a consistent control environment and comparable data that enabled programme-level oversight.
• Reporting & Decision-Support Systems: Established integrated programme reporting and dashboards providing leadership with a single, reliable view of status, cost, forecast, and risk, together with forecasting and early-warning indicators to support proactive decision-making.
• Risk & Interface Management: Stood up a proactive risk-management function and a structured interface-management process coordinating dependencies across design, construction, medical equipment procurement, and commissioning to reduce clashes, rework, and delay.
• Capability Transfer: Embedded PMO processes, tools, and capabilities within the organisation's team and trained internal staff to sustain the function, ensuring the control environment endured beyond the engagement.

• Single Source of Programme Truth: Recommended consolidating all asset reporting into a single programme management information system with standardised data definitions, giving leadership one authoritative view and ending reliance on inconsistent partner-supplied reports.
• Stage-Gated Governance: Recommended introducing stage-gated governance with defined approval criteria at each project phase, preventing assets from progressing with unresolved design, cost, or readiness issues that would surface as overruns later.
• Proactive Risk Escalation: Recommended a tiered risk-escalation protocol with clear thresholds and ownership, ensuring emerging cost and schedule risks reached decision-makers early enough for effective mitigation rather than after impact.
• Commissioning & Clinical Readiness Integration: Recommended integrating medical equipment procurement and clinical commissioning into the programme schedule from the outset, recognising that operational readiness, not just construction completion, determined the date each hospital could open.

• Restored Schedule Control: Within the first six months, the PMO's integrated controls and early-warning reporting enabled corrective intervention on the most delayed assets, recovering an estimated four months of slippage against the programme critical path.
• Cost Overrun Avoidance: Standardised cost and change control surfaced emerging overruns early, enabling mitigation that avoided an estimated SAR 180 million in forecast cost growth across the portfolio.
• Improved Decision Speed: Integrated reporting and escalation reduced the time leadership needed to identify and act on programme issues, materially improving decision speed and the quality of resource-allocation decisions.
• Reduced Rework: Structured interface management reduced design and construction clashes between assets and disciplines, lowering rework and the associated cost and schedule impact.
• Sustainable Internal Capability: Capability transfer left the organisation with an embedded, internally staffed PMO able to govern the remainder of the programme and future capital projects, delivering value well beyond the engagement period.