
The Promoter body selected for the concession for the construction and management of the new Pavilion Zero and the modernization of the existing Gaslini hospital structure
Genoa, 15 November 2022. The Board of Directors of the Gaslini Institute met yesterday evening in the presence of the president Edoardo Garrone, the vice-president Luciano Grasso, the councilors Luigi Carlo Bottaro, Andrea Del Grosso, Federico Delfino, Alberto Maestrini, Maurizio Mauri and Pietro Pongiglione and the President of the Board of Auditors Tommaso Lucia, decided on the choice of the Preferable proposal, among those identified as being of public interest. There were two proponents who reached the final comparative procedure: the RTI (temporary business grouping) with Percassi SpA, as agent, and the RTI with CMB (Cooperativa Muratori e Braccianti di Carpi) as agent.
At the end of the comparative procedure, the Board of Directors identified the RTI CMB proposal as the preferable one, among those identified as being of public interest.
With this decision, the Board of Directors has chosen the project which, after possible further improvements, will become the basis of a European tender for the awarding of the concession for the modernization of the IRCCS Gaslini hospital structure, consisting in the construction from scratch, of a hospital pavilion, the extraordinary maintenance/refunctionalisation of other pavilions dedicated to healthcare activities and complementary services in the hospital grounds and the management of hard facility management services, including the supply of energy carriers.
This is a fundamental step in the renewal process that began with the implementation of the 2021-2025 Strategic Plan, presented on 1 June 2021, through which Gaslini decided to carry out a modernization intervention of its hospital structure, also involving the projects and financing from private entities, using the model of the concession contract to adequately qualified economic operators, which then occurred through the use of the instrument of the private initiative proposal (PPP), having considered this procedure the most effective and efficient to allow the modernization of the structure itself.
Very important for the realization of the entire process was the provision of a contribution of 10 million euros aimed at the design of the new building, approved on 10 July 2021 by the Board of Directors of the Gerolamo Gaslini Foundation, chaired by the Archbishop of Genoa, Mons . Marco Tasca .
A shared process: offering more and more to Gaslini patients thanks to the participation of those who work there
On 1 March 2022, the market consultation notice was published, aimed at soliciting the presentation of Proposals regarding the implementation of the modernization intervention of the Gaslini, with the creation, from scratch, of a hospital pavilion (so-called Pavilion Zero to distinguish it from the 20 already existing), the extraordinary maintenance/refunctionalisation of other pavilions dedicated to healthcare activities and complementary services in the hospital premises and the management of hard facility management services, including the supply of energy carriers. On March 18th there were 32 requests to participate and more than 100 technicians connected for the information day scheduled after the publication of the notice. On 1 April 2022, the Superintendency received a positive opinion regarding the possible reconstruction of buildings 7 and 8, the basis of the entire redevelopment project. From 31 August to 14 November the further steps of the process were completed: from the presentation of three proposals (RTI Percassi, RTI CMB, RTI Pizzarotti), to the establishment of a working group within the hospital, which involved over 60 Gaslini professionals, for a broad, shared and qualified evaluation of the proposals regarding the technical-planning, health aspects and economic-financial sustainability, in order to identify the feasible proposal that best responds to the Institute’s objectives, according to the traditional criteria of transparency and competence, up to the drafting of the final evaluation document of the two proposals of public interest, and yesterday, finally, to the choice made by the Hospital’s Board of Directors.
The next step, after a further phase of work with the chosen RTI to make further improvements to the project, will be the tendering of the Proposal for the assignment of the construction: in this competitive procedure the chosen RTI retains the right of first refusal. This model significantly reduces the implementation times of the intervention, which would otherwise be strongly influenced by the completion of multiple public procedures (in sequence) for the selection of designers and construction companies. From the moment the construction works are assigned, the construction of Pavilion Zero (the new monoblock) will take place in 38 months. In the event of delays both on Pavilion Zero and on the rest of the interventions, penalty mechanisms are envisaged precisely to incentivize the private sector upon completion of the work within the defined timeframes
A hospital that is and remains totally public managed, but created with the contribution of the capital and skills of private economic operators.
A new hospital in its historic location: planning the future while safeguarding a past of excellence
“The Gaslini Board of Directors has chosen the proposal that best responds to the Institute’s sustainable development needs, it has chosen to begin the process of modernizing the hospital, which will allow it to continue to improve its work at the service of children throughout the world. world. We are faced with a great challenge: to make the Gaslini a pediatric hospital for the future, but at the same time to preserve intact its moral, scientific health and also historical landscape heritage, in order to guarantee the development of the Institute, which has an enormous need for more functional and integrated spaces, without moving it to another location: this project will ensure a prestigious future for our IRCCS, without depriving it of its park connected to the beach on the sea of Genoa, which Senator Gaslini chose as the best place of treatment for all children” explains the president of Gaslini, Edoardo Garrone .
“The polyclinic that is emerging from this complex transformation is a city of health, capable of further improving the effectiveness and safety of care for our young patients and the work and training experience for the entire community of operators, students, families, associations who experience the hospital every day. The new Gaslini responds to the needs of a modern integrated hub with high technological intensity, based on an organizational model for care platforms and homogeneous departmental work and study areas, organized according to the principle of intensity of care and technological complexity. A job that interprets and collects the indications of the health workers who work there and the families who frequent it. Greater efficiency in the management of healthcare activities will be achieved, thanks to a single integrated hub (Hall ZERO, 15, 16, 17, 18) which obviates the current fragmentation of healthcare services across multiple buildings. The functional organization is based on the separation of paths, with the dual objective of improving efficiency in the use of healthcare personnel and in the provision of services to the patient. The new configuration will allow us to adopt a resilient internal organisation, easily adaptable to different management needs and a dynamic healthcare service delivery logic, in line with the evolution of healthcare” explains the general director of Gaslini Renato Botti .
“The Nuovo Gaslini will be able to count on 346 beds, over half in single rooms, all with space for at least one companion and with a bathroom. The intensive care rooms will be single, in line with the most recent and efficient literature references. The entire gynecology and obstetrics department will also be completely renovated and relocated to give maximum comfort to future mothers. There will be additional comfort areas (healing gardens, rooms dedicated to refreshment and relaxation for parents, play areas for children – patients and non-patients, relaxation areas, rehabilitation rooms) for long-term patients and relatives. The IRCCS Gaslini has chosen the project closest to the wishes expressed in the notice to the economic operators: a large, complex team effort, carried out in a very short time by the hospital professionals, an extra-ordini design work, carried out simultaneously with the ordinary management of the Institute, for which I want to thank all the management, technical and healthcare, and the staff of the Gaslini” concludes the general director of the Gaslini Renato Botti.
“First of all I want to congratulate the entire management of the Gaslini Institute of Genoa for the speed with which we got here today, from the publication of the notice to the evaluation of all the proposals, carried out by a very large team of those who will have to actually work inside the new hospital, until the choice of the project which will be put to tender. The Genoese pediatric hospital, a point of reference for the care of the youngest patients at a national and international level, has demonstrated absolute excellence in this too – comments the president of the Liguria Region Giovanni Toti . The modernization of the Gaslini hospital structure, with the creation of a new pavilion and the regeneration of other spaces represents a further step forward for this reality, capable of meeting daily challenges and always remaining at the forefront, not only thanks to the quality and professionalism of the doctors, healthcare workers and researchers who work there, but also from a structural point of view. The Liguria Region has always supported Gaslini and will also do so for this important project, which will bring Genoa and Liguria even more to the center of pediatric medicine”.
“The new large monoblock and the refunctionalization of the other pavilions of the Gaslini institute are particularly important news for transforming this fundamental national and international healthcare reality also from a structural point of view – underlines the Liguria Region Health Councilor Angelo Gratarola – and achieving it towards new and strategic objectives. The new Gaslini in Quarto will undoubtedly represent a true city of pediatric health, involving not only healthcare personnel, but all the families of young patients and voluntary associations. The single rooms for intensive hospitalization and the new additional comfort areas clearly move in this direction. When you take care of a child you actually take care of an entire family, a role that Gaslini will play even more with the new project.”
“Thanks to this transformation, Gaslini will be able to improve the effectiveness and safety of care for young patients. The modernization will lead to the creation of a new, more functional, technologically advanced and sustainable pavilion, which will allow a remodulation of the entire healthcare offer, to continue to guarantee a very high quality service to the children of tomorrow. It is a great honor for the whole city to have such a cutting-edge center of excellence that all of Europe envies us. I am sure that this great challenge will be faced by all the hospital staff with pride and courage, elements that have always distinguished Gaslini. Good job everyone” declares mayor Marco Bucci .
What the New Gaslini will be like
The proposal for the Nuovo Gaslini presented by the Temporary Group of Companies made up of CMB Società Cooperativa Muratori e Braccianti di Carpi (leading company in the construction and management of the most modern hospital facilities), Mieci (Renovit group, the largest Italian energy efficiency company founded by the initiative of Snam and CDP Equity) and Arcoservizi (a company specialized in the heat management field), with the planning of the Mythos consortium (one of the main players in the sector of planning and construction management in the healthcare sector) will give rise to a profound functional reorganization of the the entire Institute, for an efficient, technologically advanced hospital, open to innovation and research and child-friendly.
The reorganization will be based on the construction of the new Pavilion Zero, the heart of the care-intensive functions: a flexible and welcoming architecture, a safe building conceived with the highest construction standards. A sustainable hospital, designed following the main environmental sustainability protocols, and strongly focused on the future. A monoblock that will integrate with the central pavilion (17-18) where there are now many departments and operating rooms.
Following the interventions relating to strictly healthcare functions, it will be possible to proceed with the strengthening of complementary services, for which at the moment only the project proposal has already been developed, in terms of: research and training (university campus with lecture hall/conference room), reception (guesthouse spaces for families on the move, researchers); company nursery and nursery, small sales areas for families and operators, spaces for voluntary associations, citizen’s help desk.
The implementation phases
The project is developed in four intervention phases, organized to guarantee the full functionality of the health areas, without interruptions to the services provided and without temporary transfers:
-the first phase sees the construction of the new ZERO Pavilion: the intervention will last 38 months and will allow the centralization of all emergency-urgency functions, with high care intensity and surgical activities for the child and mother, guaranteeing maximum operational efficiency and high quality of care. The construction of Pavilion Zero alone will increase the surface area allocated to high-intensity critical areas by 26%, allowing healthcare activities to be developed by up to 43% in the fourth year.
-the second phase , which will last 17 months, involves the renovation of Pavilions 6, 17 and 18, improving the reception and organizational efficiency of the Medical, Hemato-oncology, Neuroscience, Hospice and nursing areas.
After the first two phases, approximately 80% of the intervention will be completed: the Nuovo Gaslini will be able to carry out its activity in the new configuration optimized from a functional, health and management point of view.
-subsequently and progressively the third and fourth phases , lasting a total of 21 months, which include the renovation of Pavilions 16 and 15, where all the laboratories and departmental areas will be located.
The advantages for the child and his family
The new construction and the resulting global reorganization will allow:
– distinct and dedicated accesses and routes for: emergencies, users (with a route reserved for infectious diseases), healthcare personnel, logistics;
– contiguity of healthcare functions according to the functional links scheme;
– no areas intended for patients in underground spaces.
The introduction of “Single Family Rooms” for the right care of the newborn, with mum and dad
An inpatient area for the puerperium will be dedicated to obstetric-gynecological assistance with a totally new rooming-in in pavilion zero. The rooms will have one or a maximum of two beds, with attached bathroom. The delivery unit will be equipped with 6 labor rooms, 6 delivery rooms, 2 operating rooms and 4 neonatal islands in a dedicated area.
Pavilion Zero
The new building, consisting of 7 floors for a surface area of 30,000 square metres, will host once completed:
-the emergency-urgency area, functionally related to the hospital area of diagnosis services;
-the operating block (12 rooms, 3 of which are hybrid) and the delivery block (8 labor and delivery rooms, one of which is equipped for water births);
-the intensive care areas: pediatric and neonatal intensive and sub-intensive care (72 beds);
-the hospital area for ordinary hospitalizations (pediatric and maternal-child surgical) for approximately 130 beds.
The building is completed by two underground floors, dedicated to services, logistics and parking, and by the roofing floor where the helipad is planned, for the take-off and landing of helicopters.
The operating group will be highly technological, unique and equipped with 10 operating rooms (plus 2 for childbirth) of which one dedicated to emergencies and 9 for “scheduled” activities.
The rooms dedicated to the laboratories include a functional area dedicated to assistance – with the Transfusion Service, the Pathological Anatomy, the Central Analysis Laboratory – and a functional area dedicated to research, adjacent to each other and extending up to approximately 6,000 m2. A completely renovated area will be dedicated to the imaging area.
The management
Management is expected to last 22 years and includes the management of plant and building maintenance services, the supply of energy carriers, with the aim of maximum energy efficiency and reduction of the use of fossil fuels, through the use of renewable sources and self-produced energy through the new cogeneration plant. The project was aimed at pursuing the eco-sustainability certification of LEED GOLD buildings.
Investment and management costs
The overall cost of the works and ancillary expenses, supported entirely by the concessionaire, is 145.6 million euros; at the time of the notice, the amount was estimated at 124 million, but the increase in the price of materials and energy in recent months has made a revaluation necessary. The total of the intervention – including financial charges and other capitalized costs borne by the concessionaire – is equal to 164.4 million euros.
The fee that the Institute will have to pay following the making available of the structures (starting from the 4th year) is made up of 3 components: 1) the fee for the availability of buildings and furnishings; 2) the fee for the so-called Facility Management (FM: management of ordinary and extraordinary maintenance); 3) the fee for the energy service.
When fully operational, the total fee will be 28.2 million per year made up of 16 million for availability, 3.4 million for FM, 8.8 million for energy services.
The sources of financing
The PEF of the initiative provides, against the 164.4 million euros of the overall value of the operation, a public financing of 35.2 million euros (10 million PNRR, 6.5 million ex law 67/88 , 10 million from the Gaslini Foundation and the rest from disposals of the Institute’s real estate assets) and a private loan of 129.2 million euros. The shares represent respectively 21.4% (public) and 78.6% (private) of the overall value of the intervention. Please note that the relevant legislation provides that public financing in PPP operations can reach a maximum of 49% of the overall value. There is therefore room for additional public resources that could derive from further funding from the relevant bodies, given the feasibility of the project whose timing is compatible with the deadlines of the PNRR.
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