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This study aims to investigate the complexity factors associated with BIM-enabled projects. BIM has been widely promoted as a potential solution to numerous challenges that hinder productivity in construction projects, owing to its numerous advantages. Nevertheless, it is crucial to acknowledge the heightened complexity it introduces to project workflows, stakeholder coordination and information management.

This study employs the Delphi method to identify and extract complexity factors specific to BIM-enabled projects. A panel of industry and academic experts is engaged to discern and prioritise these factors based on their expertise and knowledge.

The study reveals a comprehensive list of 34 complexity factors that significantly impact BIM-enabled projects. Among the most influential factors are laws and regulations, variety of procurement methods, technical capabilities of teams, project manager competence, information transfer capacity, range of project deliverables and diversity of project locations. The findings highlight the importance of these factors and emphasise the need for proactive and adaptive management to navigate their impact and achieve positive project outcomes.

This study introduces the DEBACCS framework, a metric-based model designed to understand and evaluate complexity within BIM-enabled projects. DEBACCS stands for seven key dimensions: diversity, emergence, belonging, autonomy, connectivity, context and size. These dimensions represent essential aspects for gauging project complexity. By applying the concept of complexity from project management to BIM, the study offers valuable insights for practitioners and researchers. It provides a unique perspective on the challenges and considerations associated with implementing and managing BIM in construction projects. The findings have practical value for practitioners, enabling them to better understand and address the implications of complexity in BIM-enabled projects, ultimately leading to improved project outcomes.

Off-Site Construction (OSC) has received much government and public attention during and after COVID. Building Information Modelling (BIM) is an initiative discussed widely to promote OSC implementation. Although many policy promotions have been published, there are many challenges to implementing BIM and OSC in real life and questions of whether they really offer value to healthcare design professionals. This research aims to investigate BIM and OSC to understand their commonalities and differences of challenges by collecting empirical evidence from China’s healthcare construction.

This exploratory research adopted a mixed method with a questionnaire survey and interviews. A total of 261 questionnaires were received (with 183 valid), followed by 31 semi-structured interviews.

This research reveals that although both OSC and BIM face similar adoption challenges and suspicious attitudes in real-life projects, their challenges’ connotations and reasons are different. OSC faces scepticism for its customisation costs and technical constraints, while BIM is seen as limited in utility and complex to integrate. Highlighting these as socio-technical challenges, the research advocates for an integrated framework to effectively implement OSC and BIM, addressing both technical and collaborative needs in healthcare construction.

This research examines OSC and BIM within the context of healthcare construction, a focus that is relatively underexplored. The research provides a juxtaposition of the perceived and practical challenges of adopting these technologies, revealing a gap between the industry’s expectations and the current capabilities of OSC and BIM, thereby contributing to the development of modern methods of design in healthcare.