In September 2014, a real estate and procurement expert was preparing his notes for an upcoming strategic meeting with the management team of the Regional Council of Lombardy (RCL), the governing body of one of the 20 regions in Italy. The RCL wanted to analyze the procurement process for two of its most important projects: the construction of Ospedale Papa Giovanni XXIII, a new cutting-edge, high-technology public hospital; and the construction of the hospital’s surrounding parking area. During the construction of the hospital, a number of scope changes had been introduced and a major issue emerged. Construction had concluded at the end of 2012—€156 million over budget. The surrounding parking area was also subject to some issues, but with relatively minor economic and reputational impacts. Two years after the end of construction, the RCL was performing post-project reviews with the intent of improving future project procurement performance.
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