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Healthy Heart Hospital» Forums » General

Subject: Why is transferral to ward limited to 3/4 cubes? rss

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I'm trying to understand the (thematic) reasoning behind the restriction that you can only transfer patients to wards which are at level 3 or 4.

I am basically forced to leave them waiting in the waiting room until they are sick enough before I can take them to treatment. This is unless I have an O.R. which I thematically understand as a place where I need to treat severe cases. But in this game I can put level 1 patients directly to O.R.? But not to wards? That doesn't make sense in my head.
Also, I sometimes want to move a level 4 ward patient to O.R. for better treatment. But then, when I was able to heal them down to level 1 or 2, I can't move them back to the ward and get some other level 3/4 patient to the O.R.? What is this? Once I treat a patient in the O.R. below level 3 I get punished and now am forced to heal them completely or they clog the O.R. and others are dying in the ward?

I would have expected the restrictions to be the other way around:

- Wards can take patients at any level
- O.R. only receive patients at 3/4

This makes so much more sense in my head, but obviously it's not the way it was designed. Therefore I want to ask why this is the way it is? Are there balance issues otherwise?
 
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Chasseur d'Ours
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simple because you take a bed only if you are VERY seek
 
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Yes, you don't get a bed until you have a heart attack in the waiting room. But with a scratch on your arm? Right away to the operating room!

Maybe the designer can chime in, I'm really interested in an explanation and also would like to know if swapping the restrictions for wards and O.R. would have any negative effect on the game.
 
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Scott Nelson
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The limitation does help mechanically for the game. But thematically, it was added as a restriction since triage shoves the worst into the special areas. After that, expansion rooms were added. Thematically, all you have to think is that if the patient is moved to the OR without needing the OR that it is another room in a crowded hospital and the doctors might be very tricky and earn more and prestige by sending patients where they didn't need to be. As the admin, the player could play the role of a good admin, and only after the wards are full can any patient go to an OR. And only send patients out to the wards if the waiting room is filling up.

So, there are reasons mechanically as well as thematically; they may not be the answers anyone wants; they may rely on the upright citizen card to be played by the players themselves.
 
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ropearoni4 wrote:
[...] As the admin, the player could play the role of a good admin, and only after the wards are full can any patient go to an OR. And only send patients out to the wards if the waiting room is filling up. [...] they may rely on the upright citizen card to be played by the players themselves.


I like the idea of having a choice of being either nice or greedy, but something's wrong here. Rooms filling up is not a criterium for when to transfer a patient, but his condition is. I cannot be a good administrator if I can't give patients a bed until they are almost dead. I cannot be a good administrator if my level 2 patients are clogging the ORs while level 4 patients are dying in the wards.

This really pulls me out of the game. I think I will try to house-rule this and see where it goes balance-wise.
 
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Scott Nelson
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Dienes wrote:
ropearoni4 wrote:
[...] As the admin, the player could play the role of a good admin, and only after the wards are full can any patient go to an OR. And only send patients out to the wards if the waiting room is filling up. [...] they may rely on the upright citizen card to be played by the players themselves.


I like the idea of having a choice of being either nice or greedy, but something's wrong here. Rooms filling up is not a criterium for when to transfer a patient, but his condition is. I cannot be a good administrator if I can't give patients a bed until they are almost dead. I cannot be a good administrator if my level 2 patients are clogging the ORs while level 4 patients are dying in the wards.

This really pulls me out of the game. I think I will try to house-rule this and see where it goes balance-wise.


Remember Day Surgery takes a perfectly fine individual and places them in the OR to take care of stuff. Not all things are going to work thematically unless the administrator tries for some order. Placing a limit on the transfers, leaving the OR free for level 3-4 patients, could mean you lose out on money by leaving them empty. If you say that only an OR can be filled only from the wards, transfers will eat up actions. You can definitely make the game harder by sending out a memo to your doctors and staff of the order of operations that is wanted by the admin. That, in itself, is a neat idea. Can we say mini "memo" expansion?

card 1: EPIDEMIC!
a. For this game the quarrantine room is added before the game starts.
b. The yellow patients can only be transferred to the quarrantine room from the waiting room.
c. any yellow patient in the waiting room dies at the end of the round.

card 2: THEME STICKLER
a. For this game the ER expansion room is added before the game starts.
b. Any patient can be transferred to the wards if their color illness level is the highest in the entire waiting room .
c. O.R. expansion rooms can not tranferred to from the waiting room.

card 3: AS IS
a. no changes from the rules.

etc.

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ropearoni4 wrote:
Placing a limit on the transfers, leaving the OR free for level 3-4 patients, could mean you lose out on money by leaving them empty.


Perfectly fine for me. If I lose money because I chose to have the OR for severe cases, so be it. It might make sense to invert prestige rewards for that, so that the earlier you cure a patient, the more prestige you get.

ropearoni4 wrote:
If you say that only an OR can be filled only from the wards, transfers will eat up actions.


That's not what I'm after. Sure I can transfer from waiting room to OR if the patient's condition is critical enough to warrant it (according to my judgement as an administrator/doctor).

ropearoni4 wrote:
You can definitely make the game harder by sending out a memo to your doctors and staff of the order of operations that is wanted by the admin. That, in itself, is a neat idea. Can we say mini "memo" expansion?

card 1: EPIDEMIC!
a. For this game the quarrantine room is added before the game starts.
b. The yellow patients can only be transferred to the quarrantine room from the waiting room.
c. any yellow patient in the waiting room dies at the end of the round.

card 2: THEME STICKLER
a. For this game the ER expansion room is added before the game starts.
b. Any patient can be transferred to the wards if their color illness level is the highest in the entire waiting room .
c. O.R. expansion rooms can not tranferred to from the waiting room.

card 3: AS IS
a. no changes from the rules.

etc.



I love this idea
 
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Scott Nelson
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Card 4: unReal World situation:
Every round, you start with a new doctor that has not been on a shift lately. Often Doctors have to work 18+ hour shifts. This theme would place the admin in a normal hospital with 10-12 hour shifts. Perhaps the admin could pick and choose who is the doctors for that round might be, while the other 4 get some rest. Doctor training tokens might be less likely to be used, since they go with the doctor, but maybe they could come back if that doctor was on staff again?

Card 5: Earthquake!
Start with 8 rooms in the hospital. Each round, a random room is destroyed and the patients there (if any) have to be moved back to the rooms/wards that do exist or they die. Building expansion rooms are not allowed in the player actions.


Card 6: Random Rooms
Building expansion rooms is not an action for this game. Each round a random expansion room is built. Let's hope the admin have an idea what is needed. Admin would have a mitigating way to choose the expansion rooms that may be needed...for a cost, of course.
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Tom McPhee
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It does make thematic sense in a way. When someone comes into the A and E department (or ER for our non British cousins), it can be exceptionally difficult to ascertain even at triage just how ill someone really is. Furthermore simply admitting someone to hospital instantly increases the risk of them dying or becoming even more sick in a statistical sense. The main confounder being of course that only the sickest get admitted anyway but also remember hospitals are nasty places and we doctors DO harm. Sometimes it's better to not admit someone at all and to turn them away early with minimal intervention. Once we start ramming tubes into orifices and all sorts we instantly cause problems.

So I think of it like this- those who are only two cubes don't get admitted as it is hoped they'll be fine or need minimal input (people DO turn up to hospital because they have a simple splinter or their nose is running). When, on a subsequent turn that patient goes to four cubes... Well it turns out that what looked like just a mild seatbelt contusion is actually a bruised myocardium or ruptured spleen! The person who at triage said they were feeling anxious is actually more floridly psychotic and is now hearing the devil tell them to jump out the window... And those that die in the waiting area... Sadly a true reflection of how it actually is. People turn up dead or die in the waiting room.
 
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I understand that this is how it works in real life, but in this game patients in the waiting room don't get better. They only get worse.
And I am standing there, telling them that I can't give them one of my thousand empty beds because they first have to die a little more, which they surely will, because all patients in this game are terminally ill.

But instead of giving them a bed, I can shove them into OR! I can put a 1-cube patient in OR for no reason, but I cannot get him out again unless I fully heal him or he gets worse (!) and reaches level 3 or 4 at which point I can be like "yup, you're dead enough to go from OR to the station". The logic here is absolutely inverse to what I'd expect.
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Paolo D'Ulisse
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Dienes wrote:
I understand that this is how it works in real life, but in this game patients in the waiting room don't get better. They only get worse.
And I am standing there, telling them that I can't give them one of my thousand empty beds because they first have to die a little more, which they surely will, because all patients in this game are terminally ill.

But instead of giving them a bed, I can shove them into OR! I can put a 1-cube patient in OR for no reason, but I cannot get him out again unless I fully heal him or he gets worse (!) and reaches level 3 or 4 at which point I can be like "yup, you're dead enough to go from OR to the station". The logic here is absolutely inverse to what I'd expect.


I always played without this rule because I forgot about it... and I think I am happy I did... and anyway I just won one game every maybe 7-8... so in your place I would go on like this... if you have free beds why to not give to patients... then maybe after one turn you regret your decision but this makes the game even more interesting for me...
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So far I have been reluctant to remove the rule, because it probably exists for a reason and I don't want to destroy the balance of the game.

The thing is that it feels like an artificial rule that (1) tries to prevent me from making possibly inefficient decisions, which it shouldn't, and (2) goes against the theme and the spirit of the game.

If you were to remove the rule, then probably adjustments to how money and prestige are rewarded have to be made. The idea would be: The "earlier" you cure a patient (e.g. ward instead of OR) the more prestige you get. But the later you cure a patient (e.g. OR instead of ward) the more money you get. This would add an interesting balancing act between those resources and might influence your choices on where to put patients. For that to work, the PV would have to be split up into one ascending and another descending value. Or you'd have to adjust the formulas somehow.
 
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Dienes wrote:
So far I have been reluctant to remove the rule, because it probably exists for a reason and I don't want to destroy the balance of the game.

The thing is that it feels like an artificial rule that (1) tries to prevent me from making possibly inefficient decisions, which it shouldn't, and (2) goes against the theme and the spirit of the game.

If you were to remove the rule, then probably adjustments to how money and prestige are rewarded have to be made. The idea would be: The "earlier" you cure a patient (e.g. ward instead of OR) the more prestige you get. But the later you cure a patient (e.g. OR instead of ward) the more money you get. This would add an interesting balancing act between those resources and might influence your choices on where to put patients. For that to work, the PV would have to be split up into one ascending and another descending value. Or you'd have to adjust the formulas somehow.


As posted above.
This variant has not been tested but a few times (and it is usually slightly more difficult), but if theme is what you want to adhere to:

THEME STICKLER
a. For this game the ER expansion room is added before the game starts.
b. Any patient can be transferred from the waiting room to the wards if their color illness level is the highest of their cube color in the entire waiting room .
c. O.R. expansion rooms and the other similar type rooms can not tranferred to from the waiting room.
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ropearoni4 wrote:
As posted above.
This variant has not been tested but a few times (and it is usually slightly more difficult), but if theme is what you want to adhere to:

THEME STICKLER
a. For this game the ER expansion room is added before the game starts.
b. Any patient can be transferred from the waiting room to the wards if their color illness level is the highest of their cube color in the entire waiting room .
c. O.R. expansion rooms and the other similar type rooms can not tranferred to from the waiting room.


This seems to go into the right direction for me.

Some questions:
- I am free to move a 1-cube red to the wards as long as there is no other red with 2 or more cubes in the waiting room, correct?
- Can I move patients from an OR back to the wards regardless of their status?
 
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Scott Nelson
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Dienes wrote:
ropearoni4 wrote:
As posted above.
This variant has not been tested but a few times (and it is usually slightly more difficult), but if theme is what you want to adhere to:

THEME STICKLER
a. For this game the ER expansion room is added before the game starts.
b. Any patient can be transferred from the waiting room to the wards if their color illness level is the highest of their cube color in the entire waiting room .
c. O.R. expansion rooms and the other similar type rooms can not tranferred to from the waiting room.


This seems to go into the right direction for me.

Some questions:
- I am free to move a 1-cube red to the wards as long as there is no other red with 2 or more cubes in the waiting room, correct?
- Can I move patients from an OR back to the wards regardless of their status?


Yes, and Yes, if you think that would be best for the patient. In this way, the theme is what mostly counts. There are less guidelines and more freedom that the hospital win run like YOU want it to be ran.
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Awesome, I will try to play this way soon!
 
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