Systematic literature review: Long term impact of agile vs. hybrid project management in hospital projects

Healthcare organizations worldwide face intense pressure to deliver complex IT, infrastructure, and service projects amid rapid technological change, regulatory demands, and resource constraints. Traditional waterfall approaches have long dominated hospital project management, yet their rigidity frequently results in delays, cost overruns, and stakeholder dissatisfaction. Agile methodologies and hybrid (Agile–traditional) models have gained traction as potential solutions, but evidence of their comparative effectiveness, particularly the long-term sustainability of benefits beyond project closure remains fragmented and inconclusive. This systematic literature review synthesized empirical evidence on the long-term impact of Agile, traditional, and hybrid project management approaches in hospital and healthcare settings. Following PRISMA 2020 guidelines, a comprehensive search was conducted across Google Scholar, Scopus, and ScienceDirect for peer-reviewed articles and preprints published between January 2015 and February 2026. Twenty-eight studies met strict inclusion criteria. Data were extracted into a standardized spreadsheet and subjected to qualitative narrative synthesis, supplemented by quantitative extraction of effect sizes and percentage improvements were reported. Findings indicate that Agile methodologies are associated with 20–40% faster project completion and 12–23% higher stakeholder and patient satisfaction compared with traditional approaches, together with 35% greater adaptability to mid-project changes. Traditional methods demonstrated a modest advantage in budget adherence (approximately 5%). Evidence on hybrid models remains limited but suggests they may offer a pragmatic balance in highly regulated, safety-critical hospital environments. However, only one study provided longitudinal data extending beyond two years post-implementation; the overwhelming majority assessed outcomes at project closure or within 24 months. Agile approaches deliver clear short- to medium-term gains in speed, adaptability, and stakeholder engagement within hospital projects. Nevertheless, the near-absence of robust longitudinal evidence represents a critical gap in the literature. Future research must priorities multi-year follow-up studies, rigorous cost–benefit analyses of hybrid configurations, and the development of context-specific implementation frameworks to support evidence-based project management in healthcare.