Hospitals

Hi all. Just a few ideas I have for the developers, feel free to add yours!

I believe that the hospitals expansions just need a complete overhaul.

Clinics I believe are the equivalent of an Urgent Care Centre and the General Internal expansion is appropriate to mirror this in the game.

The hospitals however, I think potentially we need different types of hospitals or at least the expansions changed. A lot of the current expansions are American and we are missing so many vital expansions as well as having unneeded ones.

I think we should have the following expansions/hospitals:

- Local Emergency Department

- Trauma Unit

- Major Trauma Centre (Only MTCs should be able to be transported to by HEMS as mostly only MTCs have helipads)

(This reflects the levels of hospitals designated by a regional trauma network in the UK. A Local ED provides the basics for most patients, a Major Trauma Centre is the designated place for any patient with significant traumatic injuries. A trauma unit bridges the gap by providing higher level care than a local ED and is able to treat patients with traumatic injuries which aren’t too serious to require an MTC or to stabilise a patient ready for transfer to an MTC if the MTC is deemed to be too far away. This could incorporate the patient transfer call in the game by having patients moved between different level hospitals)

There could also be other expansions of (for specialist hospitals):

- Stroke Unit (Neuro)

- Heart Attack Centre (Cardiothoracic)

- Burns Unit

- Maternity Unit (Obstetrics)

- Children’s Hospital or Department (Paediatrics)

Although this isn’t every single department/specialty this is what I feel would be best for the game as the majority of hospitals/trusts have most specialties or share them. These expansions/hospital options should be done so that you don’t need one expansion for the other so you can for example make a hospital which is purely Childrens or just a maternity hospital which is what it’s like irl. Local EDs and their hospital are able to treat most patients however there are major trauma centre, burns units etc so that patients with serious injuries/ailments can go to a hospital that specialises in that field.

My setup is currently in the North West, I have a hospitals which are purely childrens, some are purely maternity, some don’t have an emergency department but are the designated heart attack (cardiac) centre. Revamping hospitals like this would make it much more realistic and easier to use.

Quote from chieffan36

faster release of patients would be nice

I disagree. A patient released every hour is honestly really quick. If you think about the current situation of NHS hospitals in the UK. So for example most EDs will have maybe 30-40 beds ish across all different areas resus, minors etc. they also have patients in corridors. But most of the patients in the ED aren’t from an ambulance but are from just arriving there themselves. At the moment hospitals are full to breaking point and the EDs are completely full and there’s no beds on the wards for patients to be transferred to, most patients are waiting hours and sometimes days to get out of the A&E department. So 10 slots with the option to add more and 1 being released every hour in my opinion is actually too fast.

I have previously posted about a new transport system and in it I mentioned that there should be an ability to have ambulances queue outside a hospital for a bed.

Quote from VICFire

I like some of the ideas in here. Certainly work on what expansions are available or needed would be nice as they are a direct copy from the US game, and even those are a copy themselves so not every department is used.

If helipads were to be added, it would be very expensive to retrofit hospitals with them. 24 of my hospitals have helipads whereas 25 don't (8 of those are within Greater London). I've been doing some work recently to work out which hospitals have helipads. In the following areas I've listed the percentage of hospitals that have helipads, regardless of major trauma status. SECAmb (70%), EEAS (47%), SWAS (66%), LAS (11%). London is the outlier as it's so densely populated and built up that it doesn't have a need for helipads as there are so many hospitals in close proximity and even one of the MTCs there lacks one - and that's not the only MTC in the country that doesn't have a helipad.

Some hopsitals provide specialist services without the need or capacity to be a MTC so they may be better units to fly a critical patient to rather than straight to an MTC that could be even further away.

As for the MTC idea in game, it has been planned and put forward and we were expecting it to have been released already but as you can see this is not the case. They would have the capability to have extra beds from what normal hospitals in game have. On that topic, the clinic could do with a rename to Urgent Treatment Centre but this is not a priority and may be able to be done in a hospital update in the future.

With regards to the trauma unit being a specific hospital building in game, this is unnecessary as, according to sources on the NHS website, the vast majority of hospitals have a major trauma department. Obviously this doesn't make them a major trauma centre as there are further criteria they need to meet but they can still deal with most common injuries.

Ambulance stacking at hospitals is something that was requested a long time ago. It's 'on the list' but I don't know how easy implementation is with the current transport system but really we need the better variation in hospitals first before we start stacking - and a different approach to how patients are released rather than one an hour. In my opinion, releasing a patient after 1 hour of being in the emergency department would be better rather than simply one person on the hour, every hour. Keep in mind that these patients aren't necessarily being discharged, they are being admitted onto other wards for further care.

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Ye I pretty much agree with everything you’ve said. I think you’ve highlighted some good points that I missed. I do understand that in London a lot of hospitals do have helipads however in my area of Cheshire & Merseyside there are two helipads, the Adult MTC and the Paediatric MTC. That’s it, for the whole area. But I can see where you’re coming from that based on area some may have to pay more. However, it is the players choice as to what hospitals the choose to have a helipad on.

With the trauma unit I believe it is really important, I can promise you that it exists, I’m a healthcare student but I can get some websites for you. Although lots of hospitals have ‘major trauma departments’ they often refer to Trauma and Orthopaedics, a Trauma unit is a hospital with additional capabilities such as specialist doctors and other professionals, equipment, departments etc. i believe they’d be useful in game as for someone like you in London with 4 MTCs then really it wouldn’t be much of a problem. In the North West there are only 3 adult and 2 Childrens. That’s for a massive area much larger than London, so trauma units plug the gaps.

Quote from VICFire

I think you misunderstood my comment. Only 3 hopsitals in the whole of London have helipads - all MTCs, then a fourth MTC doesn't have a helipad. No other hospitals actually have a helipad on site but this doesn't take into account local areas HEMS will land in and then convey the patient the remaining short distance by road. 27 hospitals in total, only 3 helipads.

Ah yes I did read it wrong sorry.