世界各地的医院项目经常出现执行不佳的情况，表现为超出估计成本、错过截止日期、遭受质量问题和收益不足的问题。基于这些普遍存在的问题，本文旨在通过解决以下研究问题来理解这一现象：如何理解医院项目的不当执行，以及如何减少它的发生？采用释案研究方法和意义建构的分析镜头来观察三个大
型医院项目的（不当）执行情况。研究揭示了诸如范围变化、无法适应，以及应对风险和不确定性、无效的项目管理和治理、乐观偏见等问题，这些因素联合起来会对项目的执行产生不利影响。研究认为，在该领域中占主导地位的两个理论观点不足以充分解释医院项目的（不当）执行。本研究为改善医院的采购流
程提供了建议，并提出有必要制定一个稳健且平衡的项目（不当）执行理论。

Hospital projects worldwide often experience misperformance, showing a tendency to exceed their estimated cost, miss their deadline, suffer quality problems, and yield benefit shortfalls. Considering this ubiquitous problem, this paper aims to make sense of this phenomenon by addressing the following research question: How can we make sense of hospital project misperformance, and what can be done to mitigate its occurrence? We use an illustrative case study approach and the analytical lens of sense-making to examine the (mis)performance of three mega-hospital projects. Our research reveals issues such as scope changes, an inability to adapt and respond to risk and uncertainty, ineffectual project management and governance, and optimism bias, which combine to impact project performance adversely. We suggest that the two prominent theoretical perspectives dominating the literature in this field fall short of adequately explaining hospital project (mis)performance. We provide suggestions for improving the procu ement process of hospitals and submit there is a need to develop a robust and balanced theory of project (mis)performance.