LAUSR

This study aimed to contribute to the field of project management (PM) by exploring the elements of project complexity and how individuals respond to such complexity. Multiple dimensions were examined, including technical, human and political dimensions, with a significant impact on project implementation.,An in-depth case study was conducted, focusing on the implementation of a Brazilian hospital. Data were collected through semi-structured interviews, participant observation and document analysis. Bridging the research gap involved unraveling the project complexity elements and how to manage them, more specifically in the hospital context.,The findings revealed that project complexity challenges managers to deal with uncertainties, emergencies and unexpected situations. It implies coping with multiple factors of technical, human and political dimensions. Divergent interests contributed to the formation of coalitions, triggering relevant individual and group learning. Strategic improvisation had a potentially significant response from managers regarding project complexity to make adjustments and changes, focusing on project effectiveness and performance.,The challenge of managing project complexity is to deal with the balance between structure and improvisation in response to complexity. Flexibility, adaptability, self-organisation and strategic improvisation are key elements in managerial practices that address complexity, especially in hospital projects.,The differentiated approach lies in the proposed model of project complexity, with elements that make up the technical, human and political dimensions, with significant results for complex projects.