I am sure many suggestions have been thrown out there that I might list and apologize in advance for re-listing them but here it goes:
1. Hospital Patient Times- one a day is tough because even with my hospital maxed out for patient intake, it gets filled up real quick. Maybe letting patients go relating to what they got transported for. More than likely, a nosebleed, minor car accident, animal attack, etc. would not be in for a full day. I would suggest the least amount of time someone could be released would be an hour-hour and a half because that would be realistic.
2. Having engines/ladders being able to handle BLS medical calls such as nosebleed, or a fallen person. Working in a fire rescue system that has paramedics on every rig, many falls don't require transports. Maybe incorporating a system to where an engine can clear a medical calls when medics aren't available.
3. Police Supervisors- The fire side of things is quite developed with the exceptions of AARF and water rescue. For the police side, there is aviation, swat, and patrol. I would suggest putting a supervisor in which would relate to calls. Being a SWAT medic, there is not an incident to where I would be dispatched without a watch commander, LT, Captain, etc. being there and running the scene. It allows for more realism for the people who want to play uber realistic myself .
4. Speeding up build/extension time- for those of us who don't want to pour money from each paycheck into this game, i believe there should be an option to speed up time with credits as well as coins. Maybe 200,000 or 300,000? A value to where you would have to weigh your options on whether or not you would want to spend that kind of credits on a speed-up.
5. AARF/Water Rescue- I am currently recreating the Los Angeles Fire Department and eventually I will get to LAX. I build my stations and create my units as realistic as possible. Adding in AARF units would make for greater calls as well as the realism part of things. Same goes for water rescue especially in a large system like LAFD.
6. Bomb squad- Since there are already bomb calls in the game, it would only make sense to add these units. In realism terms, the SWAT team would get deployed for a bomb scare/explosion but there is obviously a dedicated special division of a department that goes through rigorous training to be able to handle explosives.
7. Zoning- The ability to set a zone to where your department covers. In the alliance I am in, one of my buddies created the Beverly Hills FD and runs mutual aid with me and vice versa. I tend to receive calls that are right next to his stations with mine being at least 3-4 mins away from him. Being able to create a boundary/zone would take care of having to share that mission for surrounding departments.
These are the major ones that I find would help transform the game into an even better game. I chose to stay away from the small details because everyone has their own quirks that they like and would be unrealistic to cater to everyone's need.