[Question]: I have some issues with hospitalizing patients

When using an observation ward I have encountered a problem:

As far as I understand the observation room it is a room where you send either patients fresh from the trauma center after stabilizing measures to have further examinations running and to free up the operating tables there and to send patients from ER clinic if examinations are either long (requiring lab and X-Ray time) so the patient is constantly threatening you to leave or has too few symptoms thus we might end up looking for the needle in the haystack if the RNG rolls badly for symptoms.

Now, I have opened a special department as the game encourages me to and now the stress begins. Sometimes the docs will send patients to the ward even if they have something harmless like common cold - they just don't know yet. Now after the symptoms are uncovered, the patient requires me to put them into a regular ward - which at this time of the game I have not built since it can easily cost about 200k and more to have a proper one. Within the ER diseases this works well, the patients just go to the clinic, get their treatment and prescriptions and we are fine. But there are cases where special departments are involved like broken ankle. Normally, I can fix it with a leg cast in a doctor's office but once in hospitalization the patient seems to be staying in hospitalization until cured or is a lost case. The patient wants to be hospitalized in a regular ward although he can be treated at a doctor's office. I cannot send them back into the doctor's office and cure them there and the ER doc also does not bother to cure them so they can leave bed. I even cannot send them to TR. I can, however, send them into ICU but this clearly is not the way ICU is intended to work, right?

How treat you this situation? Once you open a spec. clinic you will get cases for them but you seem to not being able to forbid your spec docs to send people to the ward or have them coming back to clinic when their disease is clear. Is there a workaround? Am I doing something wrong or are mods messing with my game in an unpleasant way?


I am happy for your help.


P.S.: it creates even more problems, if you take into account that every new department will receive patients with symptoms eventually only curable at hospitalization. You are forced to buy the hospital or take a hit in reputation or even fail to achieve insurance goals like 'have no patient untreated for 7 days'. In my opinion, sending away a patient you cannot treat because you lack facilities should not result in a lost case. Yeah, the patient is gone and you won't get money (design choice but not realistic) but at least he is not a lost case. Heck, when I visit my clinic and the doc says 'I am afraid we have to do surgery here, please go to the next hospital' I will of course not be angry and answer 'How dare you not having an operating theater for exact this case!' It is obvious that I need a greater facility than a clinic which I visited. If I HAD a hospital with the according department and could not be treated because they took too long or had no beds free this is something else.

But I guess by design choice there is no way to circumvent it. This also means that building a diversified clinic first is a bad idea because once you open hospitalization for one department, you need all hospitalizations at once. Have fun grinding money for that. The game should somewhat acknowledge that certain cases cannot be treated here and not give them to us or at least compensate us for getting the right diagnosis because the patient will be treated elsewhere (get a percentage of the illness worth and no prestige penalty - you have not done anything wrong and helped the other docs speed up diagnosis).

Last point: I encountered a patient having the trait 'Pirate - does not pay anything'. Well this is trolling! Either I throw them out of my hospital and get a prestige hit or I invest time and get nothing. In real life they get a lawsuit.

If the patient is in observation with something from the emergency room, such as common cold, they won't be hospitalised anywhere else. They'll be treated in observation and released direct from there, or released from observation and sent back to doctor clinic for treatment.

If they go from observation to a ward, it's because their illness belongs to that department.

Once a patient with a department specific illness is hospitalised, they will stay hospitalised until treated.

Once treated, they will be released between hospital release hours of 7am - 6pm

If you have hospitalisation open on emergency, when you open your first clinic, you MUST open hospitalisation on the clinic too. Even if you do not have ambulances yet, patients begin to collapse as soon as you open hospitalisation on any department and, as you have discovered, you need somewhere for them to go

When you open hospitalisation on your first clinic, you must open ED hospitalisation and ICU at the same time, or you'll have collapsed patients transported away.

You can have clinic offices open, without hospitalisation, as long as you don't have hospitalisation open on ED

Hospitalisation for ED is observation and trauma rooms combined.

Because you opened hospitalisation in ED, the collapse mechanic is active. The game is also now sending you patients that need to be hospitalised.

I hope this helps

Thanks for the reply. Yes, this is just like I understand the game working. However, this is exactly my point of critique: you cannot have 'just' clinics' unless you leave out a very fun part of the game which is the ER mechanism. Once this is up - and the game urges you to go that way via insurance objectives - you just cannot have pure clinics or parts of your hospital just being a clinic.

While I understand that this depicts the reality of a hospital and usually each departments has hospitalization open and clinics are just that we are missing the ground in-between not covered. There are - at least where I live - houses shared by medical practitioners so something like a 'clinic with benefits'.

Such a clinic could have an odontologist, a surgeon specialized in mouth/jaws/facial surgery, a radiologist, a dermatologist a GP and a pharmacy in the same building. The odontologist and the surgeon can work together and the latter even has his own operating theater so they can do dental implants, restorative facial surgeries and related stuff. Still they have no ward and cannot take on patients needing days of care pre- and post surgery. They just get according cases and send away severe cases to a hospital without a rteputation hit for them and can even write a bill for their diagnostic work done before.

But this does not mean that the GP or the dermatologist in the same building can and will benefit from the operating theater as well. And hence they won't get cases for that. Patients know that they visit a clinic for dermatology and need to go to a hospital if surgery is required. They won't blame the dermatologist for being unable to use the OP room for his own clinic nor demand it.

Basically spoken, the game forbids us a slow transition from a clinic to a hospital but on the other hand lets us start with just a clinic. And new players might run into the 'trap' opening some two or three departments and like it and then their hospital collapses, once they open ER as they cannot have hospitalization for all two or three departments at once. Once ER opens, the game shifts radically. Too radically in my book..

I disagree. You do definitely need to be prepared to open the departments ... but it's a hospital. Wards are a given

Glad I could help!