Building services systems in comprehensive hospitals must support safety-critical clinical workflows within dense spatial and technical interfaces. Coordination among owners, designers, contractors, operators, and clinical users is often fragmented across planning, design, construction, and operation. This study adopts an exploratory qualitative case-study design using grounded theory coding procedures. Semi-structured interviews and field observations were conducted with 44 stakeholders involved in 10 tertiary hospitals in Shenzhen, China. Through open, axial, and selective coding, the study identifies contextual conditions, recurrent coordination breakpoints, and four lifecycle coordination mechanisms: requirement stabilization, technical integration, verification and handover, and feedback optimization. The findings show that failures in hospital building services systems are not merely technical defects. They are cumulative socio-technical failures generated by unstable clinical requirements, discontinuous responsibilities, weak knowledge translation, and delayed decisions at stage interfaces. The proposed model reframes coordination as an iterative lifecycle process and provides an analytically grounded framework for diagnosing coordination risks and organizing stakeholder responsibilities in complex hospital projects. Its effects on project outcomes require further validation through future implementation and comparative studies.
Shangyan et al. (Mon,) studied this question.