Despite its rapid growth in recent literature, risks in project management have received limited critical attention when compared to Lean principles and total quality management. The aim of this article is to examine the ongoing dialogue within health services funders and providers concerning the relationship between project management and its relationship to hard and soft environmental risk factors. The failure of high profile projects and cost to the taxpayer is on the increase. This article argues that the lack of understanding in relation to a holistic assessment of project success factors contributes to increased risk of failure. It argues that greater emphasis is needed on placing risk relative to both operational and cultural factors, as opposed to the frequent use of prescriptive mechanistic methodologies. These changes have the potential not merely to improve the success rates of healthcare management projects, but health outcomes too.

Traditional methods of project management are not appropriate for complex projects anymore. Since projects are becoming increasingly complex and uncertain, interaction between activities and resources is growing in ways not considered by these methods. Nowadays, managers need more agile project management methods that are able to recognize and deal with uncertainty and to produce the expected results. Lean project management, the most recent approach of lean methodology, appears as an alternative approach capable of dealing with complexity and uncertainty. The latest investigations in the field show that traditional methods are still adequate for simple projects, while lean methods are more appropriate for complex projects. This thesis aims to investigate the nature of lean project management and to examine project risk management processes so that managers can assess the complexity of projects before their beginning and decide which method to apply in order to manage them.