Support to the San Giovanni Battista Hospital

Project location: ITALY, Rome
Project start date: September 2004 - Project end date: This project covers various years
Project number: 2004-22
Beneficiary: ACISMOM

Renovation and Adjustment in Compliance with the law LR 4 / 03 of a Hospital Ward in the San Giovanni Battista Hospital, Rome

[2008-32]

The project co-funded by the Nando Peretti Foundation aims at renovating a hospital ward, which includes 32 rooms each of which contains 6 beds. Work shall be done in accordance with the new Italian legal requirements for healthcare accreditation LR n.3/04. According to these requirements, hospital rooms can contain only 4 beds, in addition to all the necessary fixtures and fittings modifications provided for all healthcare related premises. This reduction of beds has led to the need to create a new department in the hospital currently occupied by the awakening department. The new section will be completed on both the whole of the second floor, which is presently occupied by surgery, and on the first half of the first floor where the awakening unit is. Rooms properly fitted for hospital stay require structural interventions on the building.

Description of the restructuring
Works will be mainly of two types. The first will be on the current hospital ward, and will involve remaking the floor coverings and false ceilings and a complete makeover of the electric system, the data transmission system and all signals and signs. From an architectural point of view, a small living room will be built inside the rooms in the space adjacent to the beds. Internal and external fixtures will be replaced in compliance with new regulations on energy saving. Restrooms will be completely redone to meet requirements for the disabled. Water, electrical and air-conditioning systems shall be entirely redone, using the roof and vertical pipe ways. Air-conditioning is guaranteed by a system of ventilation and air supply that ensures standard hydrothermal levels in all seasons in the patients' rooms and in the rehabilitation gym, with a degree of control in each room. In all departments medical gas equipment (empty and oxygen) will be installed on each headboard.
Works consist of internal restructuring of the building, since the exterior is not included, not even in the renovation of the facades.

The second type of work will be structural. The building in question is constructed with a rectangular framed reinforced concrete structure of sides approximately equal to 40 x 17 m. The structure is 3 floors plus a cover that has two slopes with central ridge. The structure is composed of 10 cross over span frames. The frames have the same geometric dimensions, with the exception of the two end frames which have a limited extension. The facade of the building is jutting relative to the ground floor and is supported by cantilever beams of variable section. The mesh of the pillars, in some cases does not lend itself to the new functional requirements of the building. The structural renovation work thus arises from the need to partially demolish 3 pillars which form part of the transverse frames No 2 and No. 8 (figure below). In particular, two pillars of the frame n. 2 will be demolished on the first and second floors, a pillar of frame n. 8 will be demolished only on the second floor.
According to the provisions of the Ministerial Decree 14/01/2008, § 8.4, the intervention may be regarded as "reinforcement or local" in that it involves individual parts of the structure and affects a limited portion of the building.
Structural interventions are aimed at ensuring that there will be no reductions in safety levels of the existing construction, in terms of strength and stability under static and seismic events. Thus the structural performance of the frames affected by the demolition will be restored or improved through the strengthening of existing structural elements or the building of new structures as better specified below. 
From a static point viewpoint, the vertical load currently carried by the pillars to be eliminated will be transferred to adjacent pillars after reinforcement and adjustment of the pillars and connected main beams. The reinforcement will be performed by linking steel structures or fiber reinforced woven composites to existing parts.
The pillars of the facade will also be extended to the ground floor by erecting new metal profiles to be set on new foundation plinths of reinforced concrete. From a seismic point of view, the intervention is designed to preserve or improve the capacity of the frames affected by the demolitions to resist to horizontal actions. For this purpose some pillars will have reinforcement rings made of reinforced fiber composite materials that increase both the resistance and ductility, while retaining the characteristics of lateral solidity. The latter aspect aims at ensuring that the distribution of horizontal actions between the various cross-frames is not substantially changed by the interventions.
During planning of the structural interventions, a visual survey campaign was carried out to ascertain the significant aspects of the structural elements, such as their geometry, the texture and type of floors. In the course of the work it will be necessary to carry out further investigations to determine the characteristics of materials (samples of framework and extraction of cores of concrete for tensile stress and compression tests). These investigations can be occur along with  non-destructive testing (combined ultrasound-sclerometer - Sonreb Method surveys).
On-site tests might be necessary upon completion of the works to verify proper implementation and effectiveness.

List of planned operations
1. Investigations and surveys of existing structures (geometry and mechanical properties of concrete and framework)
2. Buttressing of beams and floors
3. Removal of plasters and finishing
4. Reinforcement of 4 existing reinforced concrete beams with steel or reinforced fiber composite profiles (total linear development = 28 m)
5. Ring reinforcement of 8-10 existing landing pillars with fiber reinforced composite materials (total linear development = 16-20 m)
6. Reinforcement of 6 existing landing pillars with steel profiles (total linear development = 18m)
7. Construction of 2 ground floor new steel pillars (total linear development = 6 m) and 2 reinforced concrete foundation plinths
8. Construction of a new steel beam on the second floor (total linear development = 6.3 m)
9. Demolition of 5 reinforced concrete landing pillars (section approx. 35x35 m, total linear development = 15m)
10. Reconstruction of plaster and finishing

Construction works financed with the contribution of the Nando Peretti Foundation

The contribution of the Foundation will be used for renovation of the Lepanto building hospital ward and adjustment in compliance with the Lazio regional law LR 4/03 of the San Giovanni Battista hospital of Rome.
The department covers two floors with a total area of 1130m2 and includes 40 beds in 20 rooms with two beds. The adjustment includes both normative structural interventions and new furniture.

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