StructSure-BIM: A Risk-Based Digital Assurance Framework for Reinforced-Concrete and Post-Tensioned Works in Hospitals and Complex Buildings

Structural quality assurance in hospitals and other complex buildings must coordinate reinforcement, formwork, post-tensioning components, embedded services, openings, concrete placement and approved design information before irreversible work is covered. Conventional inspection checklists provide necessary control but may not express why one inspection lot requires greater assurance than another. This paper proposes StructSure-BIM, an engineer-controlled BIM-linked framework that assigns transparent assurance priority while maintaining formal witness and hold points. Ten interpretable criteria represent element consequence, reinforcement complexity, evidence deficiency, drawing-change exposure, embedded-item density, method maturity, post-tensioning sensitivity, concrete sequence, nonconformance history and inspection access. The artifact is computationally tested on 80 reproducible synthetic inspection lots generated with fixed seed 2032; no employer, client, patient, hospital or live-project data are used. Scores ranged from 5.0 to 94.7, with a mean of 52.9. The model allocated 20 lots to standard inspection, 22 to coordinated hold points, 23 to enhanced assurance and 15 to critical release. Median tier stability was 100% under 1,500 weight perturbations per lot, although the least stable boundary case retained its tier in 64.7% of trials. A controlled evidence-improvement scenario reduced assurance priority by 9.8 points on average. Artificially suppressing embedded-item and post-tensioning exposure understated priority by 7.4 points, illustrating the risk of incomplete multidisciplinary coordination. These are computational stress-test results, not evidence of field performance or defect reduction. The contribution is a traceable specification linking BIM objects, inspection evidence and release authority. Expert calibration, authorized project pilots, inter-rater testing and code-specific acceptance rules are required before implementation.