Abstract Earlier research has demonstrated that in a project organization, project identity is a central leadership vehicle that offers a useful means for examining and developing shared interests and goals among project participants. However, little research has focused on project identity formation and identity maintenance.

We focused on the case of a large hospital construction project and used a qualitative research method to create propositions describing the essential identity formation activities that the program management office (PMO), the project director, and together with the project management team need to intentionally undertake in the early phases of a hospital construction project and corresponding identity maintenance during the project implementation period.

The findings indicate that identity creation and formation is initiated from the first meetings at the project front end and naturally evolves, but significant intentional actions need to be organized and controlled at the front end. Identity maintenance as a deliberate managerial action should take place during project implementation to keep identity alive as a positive resource, not resulting in the identity fading away to something else.