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jjjezb

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Ideas from a fan and a nurse
« on: April 13, 2012, 05:26:59 PM »
Alrighty, as a mahoosive fan of the Theme Hospital i have loadsa of ideas for the game, many of which might be repeated so just to make things easier;

1. I'm going to try not to talk about all the fantastic new disease ideas unless it refers directly to something i'm talking about.

2. I'm going to talk about how the gam could be made more realistic to a point, but not unrealistic to develop or create.

3. I'm not a coder or programmer or similar so much of what i say will be about concepts of how hospitals in reality tend to behave (with my example taken from the NHS).

Also apologies for any spelling errors etc also! ;)

Ok. So as a Nurse i have to say that often we are shoved out of the limelight in terms of how we are potrayed across the entire media spectrum and obviously we do more than work in wards and we NEVER work in 'pharmacies' pouring liquids down patients throats as they stand there. After all if they can open the door then they can take medication themselves. So alot of this is from my perspective and will bring Nurses more to the forefront of the game.
I want to bring in more members of the healthcare team because obviously Physicians certainly do not operate XRAY machines, CT scanners or MRI units. Radiographers do and in most countries psychiatric emergencies are only briefly handled in A&E/ER departments before seperate mental health services take over. That said here is my very long list of things i would love to see or talk about.

So we'll start from the front door and bundle all the patients turning up together as if it really were an A&E/ER with a variety of patients coming in. Those who can will register at the reception desk and wait to be triaged and those who need prompt attention will be seen more quickly. Those who arrive with dire symptoms or via ambulances will always bypass receptions altogether and head straight to 'Majors' or 'Resus' so with that in mind the first item of building a hospital capable of taking every patient is to build the A&E/ER

Accident and Emergency Department/ Emergency Room

Prospective buildings.

1. Triage Room.
The triage room is where stable patients are briefly assessed (almost always by a Nurse in the UK), their symptoms listed and BP, temp, O2 levels, blood sugar etc taken. A history of allergies and medical history is always taken and can take as little as 10-15 minutes.

Staff:- Senior Staff Nurse
Room Size:- 4x4
Equipment:- Desk and chair with computer, chair, BP machine

2. Minors
Minors is the area where patients with minor injuries and ailments can be seen and treated. Essentially it is a trolley/guerney area surrounded by a curtained enclosure. Patient can recieve all basic elements of their assessment, diagnosis and treatment in this area. The idea is that none of these patients will require admission. One minors slot is the minimum but in reality many more are required. Both Doctors and Nurses are needed for this area to function on a ratio basis.

Staff:- Physician (any grade) Staff Nurse (1 Nurse per 4-6 trolleys)
Room size:- Each trolley space will occupy 2x3. More than six trolleys requires a Nurses Station
Equipment:- Trolley/Guerney (with automatic curtain/screen), BP machines, treatment trolley, BP machines, Nurses station, bedside chair, name board (for logging patients)

3. Majors
Majors is the area where more acute patients are seen. Much of the layout is the same as the minors area except there are proper beds instead of chairs, the area is slightly larger and the walls between the beds are solid with a curtain at the front only. Each bed will have monitoring equipment i.e. wall mounted BP machines, ECG etc and as such requires a greater number of staff. In aiddition more Senior Doctors and Nurses are required to both run and manage the area. Patient here recieve a higher priority in terms of access to diagnostic units and inpatient areas.

Staff:- A Senior Doctor (e.g. SpR/Chief Resident) and a Sister/Charge Nurse to run the unit
       :- A Physician (any grade) per four beds, One Staff Nurse per four beds.
Room Size:- Each bed space will occupy a 3x3 footprint. A Nurses Station is non-optional regardless of the size.
Equipment:- Bed, chair, Nurses Station, Monitoring Unit (includes a defib'), treatment trolley, name board.

4. Resuscitation Room
The most important room of the department. Any critical/life threatening or seriously injured patients arriving by ambulance or not will go straight though to resus. It has the most equipmnt to stabliize patients, reverse serious symptoms and to deliver essential life saving treatments and therapies. As such it requires a high number of skilled staff. Receptionists will call certain 'codes' to summon allocated staff if the room is empty or there are empty beds. If the room is full, overspill can occur but the player will have the option to declare it is unable to handle the emergency. The resus room contains diagnostic equipment only for the use of resus patients and must have a minimum number of staff assigned at all times to remain operational. Staff allocated to the resus room can not be re-allocated without a pop-up warning for the player or unless duties are assigned to another member of staff.

Staff:- A Consultant/Attending and a Sister/Charge Nurse must be present at all times to run and manage the resus room and must see every patients themselves.
       :- A minimum of two physicians (any grade) and two staff Nurses per bed space
       :- Further bed spaces require the allocation but not neceassarily the placing of one doctor and nurse PER bed.
       :-Radiographer (for XRAY)
       (NB. This seems high but it really for the realism factor. There may not be emergencies of this nature all the time however this does mean that staff can work elsewhere in the department but be allocated for resus codes when needed)
Room size:- Each resus space is 4x4 and must be co-located. There is a great deal of equipment needed however.
Equipment:- Resus trolley/guerney, monitoring unit (free standing), Nurses station, XRAY machine, treatment trolley 

5. Plaster room
No A&E/ER would be complete without a Plaster room for the setting of broken or fractured bones. In reality many breaks can be plastered and the patient sent home depsite the modern fascination with surgical intervention. Patients, obviously must have an XRAY diagnosis and be approved for a cast beforehand and then sent for an XRAY afterwards but this treatment room is likely to be a real money earner (!)

Staff:- Any Physician or Staff Nurse who has completed the Plaster technician course
Room size:- 3x4
Equipment:- Wet Plaster cupboard, Plaster table, Chair, Sink

6. ECG room.
This room is probably not hugely necesary but it is realistic. It is specifically for patients of any kind (except obviously resus and most majors) who present with chest pain. IN any A&E/ER claiming chest pain will jump you to front of all but the worst queues where a 12 lead ECG will be immediately taken and shown to a Doctor who MUST drop eveything and analyze it. Significant steps to avert an MI (heart attack) can be instantly administered ranging from 300mg paracetamol/Acetominophen orally to a diagnostic PCI. Having this room is very cardiac specific but heart disease is common and it might be a cool idea anyways.
It would be a 2x3 room with just a 12 lead ECG machine. Very little else is needed and it can be operated by a Nurse.


Alright so that concluded the Emergency Services section so far. Other ideas i've thought about include an ambulance bay that can be added on creating a seperate entrance but most of the other ways of expanding emergency services merely include the incorporating of other rooms into the department thus linking certain areas like diagnostic rooms, operating theatres nd so on that could be specifically for emergency patients. This makles things more interesting and complex - which one can either love or loathe.

Next i'll be talknig about the various diagnostic facilities that hospital usually have and how certain tweaks to existing rooms and the creation of others could improve the dynamic of the game further.

Cheers. jjjezb!
« Last Edit: April 13, 2012, 05:30:48 PM by jjjezb »

jjjezb

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Re: Ideas from a fan and a nurse
« Reply #1 on: April 13, 2012, 07:58:49 PM »
Hello there and welcome back to part 2 of my 'Ideas from a fan and a nurse'. Obviously mere minutes have gone by since i started but i do love this game so it's probablybest to keep up the momentum from the last post and move right on to Diagnostic Equipment. So, of course no sane person goes to hospital just to be poked and prodded by Doctors and Nurses without expecting at some point to be scanned, monitored, probed or otherwise examined by a variety of diagnostic machines.
There are some obvious issues with Diagnostic medium that TV has always managed to get away with which must really annoy those people who actually do work in those clinical areas so firstly i'll just briefly go through those.

1. Physicians operating all the equipment.
  In real life radiographers (and sonographers) operate the vast majority of diagnostic equipment with Radiologists using equipment only for the placing of things such as drains i.e. tapping fluid collections, placing lines etc. Outside of this if the diagnosisis to 'help the doctor' it is unlikely the doctor, whatever the area will even be there. In terms of XRAY's and CT's Radiologists (in the NHS) will sit in an office called the 'Hot Seat' and will literally view and describe every image that is taken. They will descrbe what they see and it will appear on screen or if requested by the requesting doctor be given as a phonecall. Otherwise you will NEVER see a doctor in the room, much less using the equipment. Doctors NEVER accompany stable patients to diagnostic areas and they are not in charge of the radiographers whatsoever. So by all means have Doctors that are RADIOLOGISTS and even nurses working where needed but they need to either be in the hot seat (which could be a mandatory mini room akin to the research lab) or working in procedural rooms alongside radiographers. e.g. angio, theatres etc.

2. The non-presence of radiographers anywhere.
 Radiographers work everywhere where an XRAY is taken so will appear in Resus, A&E/ER's, Operating Theatres, Outpatients and so on. Radiograhers also inject contrast mediums for XRAYs of soft tissues and oral contrast mediums themselves and where i worked this reqired no consent form or presciption.

So those two problems created one for the game which is WHO should operate all that equipment.
Well i think that it should be the RAdiographers so there will be a need for an entire new class of staff.It seems ridiculous that a doctor would train at medical for five years (i know the Americans like to spend an eternity doing their training) to not practice medicine. That aside, onto the rooms!!

Diagnostic Rooms.

Most of the rooms are fine just the way they are so apart from changing the person operating it the following rooms would remain virually the same, comedy animations and all.

1.XRAY
2.CT Scanner
3.Ultrasound
4.The Cardiogram certainly doesn't require a Radiographer or a Doctor so i would change the Cardiogram to Nurse led room (despite the fact that we don't run cardiograms hiring a class of technicians does make things more complex than necessary)

5.The Blood Machine is great to have if you value quantity of rooms over the quality of service that they provide. I for one would rather blood was taken wherever it's needed as opposed to wasting an entire room on phlebotomy.

New rooms.

6. MRI unit.
Extremely expensive and not for every patient, MRI scanners give detailed images of patients innards. They require more than one radiographer and can't be used by all patients as they require a metal free environment and patient!!

Staff:- Two radiographers (+allocated Radiologist in the hot seat)
Room size:- 6x8 (MRI units are huge!)
Equipment:- MRI room, Control and Viewing Room, Prep/Changing Area.

7. Endoscopy Unit
Endoscopies are used to visualize the patient's alimentary camel to see blockages and areas of inflammation or tumours etc. THey are well established and would more than make up for losing the blood machine room. Usually they roms ae like mini day surgery units with a small ward area and an endoscopy room for the procedure. I suppose the waiting area can be for patients following the scope and can wait outside before hand so the turnover can be continual. Endoscopies are performed by either Doctors (or in the UK by specially trained Nurses).

Staff:- Doctor with two Staff Nurses for the room, another for the waiting/recovery area.
Room Size:- 6x8
Equipment:- Endocopy Room, Waiting Area, Nursing Station, BP machine

So that's all i can think for for now. I mean any further and we start moving into angiograms which are quite staff heavy and nuclear medicine which hs it's own issues. Imean, i love the idea of angiograms being performed so they might be a great idea after all. But that concludes the diagnostic area part. I'm leaving quite alot as it is.

Cheers. jjjezb!
« Last Edit: April 16, 2012, 09:15:43 PM by jjjezb »

jjjezb

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Re: Ideas from a fan and a nurse
« Reply #2 on: April 16, 2012, 09:06:44 PM »
Alrighty, hello again and welcome back to part 3 of my 'Ideas from a fain and a nurse'. Today we're going to talk about one a few linked areas that straddle Diagnosis and Treatment areas, specifically wards. This is of course my areas of expertise in how they function and what could be improved, upgraded or changed for the better of the game.
So wards are the real deal area of hospitals and cope with the widest variety of patients. Contrary to popular belief, a great deal of the time the most difficult to manage and unwell patients are actually found, not in Intensive Care Units but ordinary wards where they are primarily cared for by Nurses with far less contact with Physicians or Surgeons. Ward Nures tend to have far less resources in terms of people and equipment, though many of us enjoy the challenge to develop our skills and practice with far greater autonomy and influence in the decision making process.
That said, let's go over exactly what it is that wards do.

1. Admit patients from A&E/ER's and begin (but more typically establish and implement care)
2. Continually assess, monitor and treat such patients.
3. Provide the bulk of recovery from surgical procedures
4. Dispense regular and copious amounts of drug therapies
5. Liaise with other members of the healthcare team and with relatives.
6. Advocate for the patient, safeguard the patient against any and all harm.
7. Educate patients in the interim period before discharge especially if their overall function or needs change.
8. Fill in the gaps between the patient and the lesser numbered AHP's (Allied Health Professionals)
9. Document all manner of patient activities, changes etc etc.
10. Plan and provide a safe discharge or transfer including setting up care needed outside of the hospital.

IN terms of the game there is a great number of issues that wards can do rather than have patients come in and out, or wait before surgery. The game doesn't appear to cope with the theory of more than one ward either and happily function with just one person and it is the application of more realism that i think will transform the game to something a bit more in depth.
So here we go.

The major changes.

1.
Wards can be allocated to several different kinds of patient or to all. i.e. the player will have the chance to use a drop down menu to choose medical or surgical, men/women or unisex (And even perhaps children or pregnant women if the game was to really take off - though in the UK we would definitely want a midwife patch!)
Furthermore the player will have the chance to choose between taking patients whose diagnosis is not complete or patients who are 'going to' have treatment of some kind. This will allow the player to stream patients into different areas for convinience and efficiency.
Thus the A&E/ER will be able to have its own ward, this will definitely geneate a faster turnover and prevent a backlog of paitents whose diagnosis takes time.
The Operating Theatres will be able to have dedicated surgical wards.
Medical patients will be able to recieve pharmacological therapy in a dedicated area.
The idea is generally as aforementionned efficiency with a good dose of realism.

2.
 More staff are definitely needed and will be on a ratio of Nurses to bed numbers and each ward (or set of wards). This ratio can be changed with a cost/efficiency ladder. e.g. 6 Nurses and 6 beds equals the highest possible interview, but astronomical cost. 1 nurse to 6 beds (realistic for the UK in many areas) will have a normal efficiency rating and a normal cost.
Each ward will also require a Nurse to function as Ward Sister/Charge Nurse or shift leader in their absence which will attract an efficiency and safety/quality bonus. After a certain point the Charge Nurse position must be mandatory.
Another idea i like is to have Assistants/Aides that can be alloted to any clinical area, again with another efficiency and safety/quality bonus.
The beds will be divided evenly between the staff and new animations will be able to show the nurses giving drugs, doing dressings, taking BP etc and whatever other tasks. Curtains at the bed areas can even be draw for 'duties requiring privacy and dignity.

3.
Doctors et al will visit the patients on a 'daily basis' hopefully in teams with the Consultant/Attending handing out orders to his/her juniors.
 In terms of a Surgical team for example, the Consultant would see patients early in the morning, perform surgery all day and in a few cases re-visit the ward later that day (though not usually in my experience). Their juniors, excepting Registrars/Chief Residents tend to do the day to day work responding to Nurses requests to see patients or prescribe/diagnose the daily problems and so on. The Registrars/Chief Residents, Senior House Officers/Residents tend to occupy a grey area between Outpatients, Theatre and the A&E/ER and visit patients/advise the House Officers/Interns as and when they can/where it is urgent.
So it is fairly complicated but as your hospital grows a ward can gain more than one Consultant/Attending which would provide cover. in fact it would be better to spread your teams across wards so staffing isn't a problem.

Thus a single ward might look like this.

Ward A - Surgical
Consultants/Attendings:- Mr/Dr Yea, Mr/Dr Nay, Miss/Dr Oivay, Mr/Dr Ohkay.
(NB In the UK Surgeons are never called Dr they are always Mr and Miss (not sure why not Mrs)).

Ward B - Medical
Consultants/Attendings:- Dr Dare, Dr Rare, Dr Blair, Dr Bear

Each team might have say three or four juniors each working towards promotion, thus Registrars/Chief Residents can gain their own leadership positions after training and experience. I'll go into the training aspect in ore detail later but as it seems relevant to wards in this discussion i sort of feel compelled to mention this aspect now.

4.
Wards will require other healthcare workers too such as physios, dieticians, pharmacists. Again i'll go into this more later

5.
All inpatients on wards will be placed on the inpatient list in which the player will be able to see their current status, how far through their treatment they are, how well they are and so on. Thus the player will be able to see at a glance who is in their hospital and for what, the bed status and whether the health of the patients is manageable - as well as overall efficiency and capacity. Patients who require immediate intervention or are about to expire through ill health or delays will be mentionned by the advisor, thus this will be a function the player is unlikely to want to turn off!

6.
Wards will require supplies or medicine, equipment and so on. Drugs from the pharmacy and single use equipment from stores which can be automatically topped up like supplies in theme park only automatically. The cost and the quality will be the issues for the player rather than the volume of supplies.

7.
Wards of more than 8 beds will require a ward clerk/administrator again providing an efficiency/quality bonus. Generally they will function akin to the receptionnist but will be where the player goes to for info regarding numbers, capacity, efficiency etc etc leaving the clinical focus to the clinical staff. They will have their own area of the nurses station which will be a larger model.

8.
Wards will be more cleverly designed with the need for toilets and storage.

So there we have it, in summary the wards can be of multiple type and multiple function. They will have more staff and there will be alot more to it than the laying in bed and nurses walking past aspect. The best part is that THIS can be a real money maker. The cost of repeat drugs, 'bed hire' and staff pay will get the most out of your insurance and trhere's nothing they can do about it. Mwah ha har!!!
But for real real, it's about going more in depth for a better game experience.

This was quite a long one as i suppose i felt that it was neccessary to 'big up the nurses' role and give them a more realistic set of attributes. I do of course get that re-defining the wards does make the game more difficult to reproduce and maybe even play. But that's kind of what i want out of a modified version of this game (or a sequel) so it does make sense to say what you want now.
Alrighty that's it for now, next post is going to be about the the Operating Theatres and Critical Care within my dream Theme Hospital and just what i propose to really add a cool layer of awesome so see you then!

Cheers. jjjezb!


« Last Edit: April 16, 2012, 09:12:25 PM by jjjezb »

jjjezb

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Re: Ideas from a fan and a nurse
« Reply #3 on: April 18, 2012, 05:11:36 PM »
Alrighty, hello and welcome to part 4 of my 'Ideas from a fan and a Nurse'. As aforementionned i'm going to talk about the possibilities and ideas regarding further development of the Operating Theatres and the provision of advanced inpatient areas such as Critical Care Units.
So let's jump right in with what i consider to be the easier of the two topics - the Operating Theatre - which is one of my favourite rooms. I say favourite because at the same time, it can also be one of the most frustrating if you have a shortage of surgeons, especially as you cannot single them out in particular to work only in those rooms - not that the Receptionnist prompt doesn't work.
Generally i prefer to have a minimum of two Operating Theatres on the later levels and more commonly three usually with one large ward of no less than 10 beds. Together these rooms are a cash cow, but come with the obvious problems of queues and delays. It was extremely common to have four patients waiting for each theatre with a patient already on the table in each room, thus to maintain flo i tended to just guy new tables rather than wait for them to be replaced. I would at the same time occasionally have queues of up to 10 people for the ward aswell but that's a different subject.

Of course Operating Theatres are a great deal more complicated than our beloved game makes out and what i would love to see is more of that complexity portrayed in an updated version with some conviniences for the player that bypass the issues faced in te original game with staffing et al. So i'll just dive right in and get on with it.

1.
 I would prefer surgical patients to be taken to the Operating Theatre on their bed (we don't have to have a porter because i guess the Nurse can push them there). I don't think it would take much to arrange that graphic and it adds to the depth of the game to see patients travelling around in beds.

2.
There should be a new speciality for Doctors, Anaesthetists (I know in the USA the term Anaesthesiologist is used by i'm to UK terms here just to save on the typing!). The Anaesthetists would obviously provide anaesthesia and monitoring for the patient using an anaesthesia cart which really is an additional attachment to the Operating table graphic including a stool at the head end. The upshot of the Anaesthetist is that they can anaesthetize the patient before the surgeons even arrive meaning they get to turn up, cut away, finish up and go! This definitely adds more variety and versatility to the game and is a necessity.

3.
There should also be a Scrub Nurse in the Operating Theatre as well. They assist both surgeons, maintain the sterile field as well as provide safety via counting swabs and instruments etc etc. Thus we have four people in theatre for the patients operation. Thismight sound like a bit much, but what i'm going for is more depth to the game to actually make it more complex - especially for us that enjoy the game but want more challenges from a new version. If i really wanted to be a pain however i'd insist on a Circulating Nurse as well but i think we can draw the line under the Scrub Nurse as the 4th essential person. THe Scrub Nurse can also keep the patient on the table and ready for the surgeon even before they arrive alongside the Anaesthetist as well as keeping the room prepped.

4.
All surgical patients should be moved to the Recovery Room or the ICU by the Scrub Nurse and the Anaesthetist BEFORE returning to the ward. This is more in-line with current practice and of course is billable!
Here patients will recover from the Anaesthetic (ONLY) before they are well enough to be taken back to the ward. The patients need only spend a very short time here.

5.
The Operating Theatres like the wards can be assignable to different criteria lke emergency patients, electives, certain types of surgical procedures even.


I would also love to bring in personnel like Radiographers for operations for that added level of cool, things like Spare Ribs and so on really ought to have XRAYs done before closing but i think that might be overkill so that can go on the back burner i suppose. So just to recap we'll go over the Operating Theatres criteria.

Operating Theatre.

Staffing:- Two Surgeons (required in Operating Theatre!)
           :- One Anaesthetist
           :- One Scrub Nurse.
Room Size: 6x6
Equipment:- same as before but now including; Anaesthesia cart, scrub trolley

Now onto the Recovery Room and Critical Care.

So anyone who has had an Operation will have woken up in the Recovery Room a windowless area where the anaesthetic is reversed metabolised and the patient is extubated and is carefully monitored until they have reached acceptable levels of consciousness and function. This is for a few principle reasons.

1. The anaesthetic is usually the most risky part of the operation. Inducing a coma and then a reversal is highly dangerous which is why usually the anaesthetist sees you BEFORE the operation.
2. Post anaesthetic complications tend to occur here first and as such there is often a 1:1 nurse patient ratio.
3. The patient can often be taken straight back to theatre without delay if there is a problem which requires surgical intervention.
4. The anaesthetist will be able to review the patient and agree their discharge back to the ward.

Plus a new room is always great for the game. So let's just go over the criteria/design et al.

Recovery Room.

Staffing:- One Anaesthetist
           :- One Nurse per two beds. (More than four beds requires a Nurse in charge position)
Room Size:- 5x5
Equipment:- Bedspace/monitoring unit, nurses station.


So now onto Critical Care, Most hospitals have an area for their seriously ill or injured patients and this would be a great room to bring into the unit - not just because of the great financial cost the player can gain but also as it can bring a certain amount of prestige to the hospital. It covers a variey of different illnesses so can work with physicians and surgeons and brings in that all important complexity to the game without being too far-fetched to pull off (not that i'll be the one doing the coding etc!!!)

So essentially the ICU (Intensive Care Unit) will be akin to the ward except patients will stay here longer, require greater input from multiple staff. The patient can be admitted either from A&E/ER, the wards or straight from the Operating Theatre and can stay for a decent amount of time before being sent to the ward. I think this room will be alot of fun with a healthy dose of frustration for the player as there will be a limited number of beds. The player can decide whether to be mean and kick them out to the wards (with all the risks entailed) or whether to stick with the plan even if it creates delays elsewhere. Obviously it requires work to create the criteria for admission but i think that as a small amount of patients overall will require ICU compared to the ward or other areas it will be realistic as well as useful.
The point of the ICU is to provide for patients who are seriously ill and try to 'get them back' rather than them simply dying. For example patients who have a reaction to drugs that would normally kill the could be admitted to the ICU instead. Also patients who are undergoing difficult operations can be put here afterwards, greatly improving their outcome. Furthermore patients who make it to the Operating Theatre but have the 'rotting smiley' over their head should go to the ICU.
Normally staff rooms are internally located but i think this won't be a problem. One the other hand i think the unit shouldn't be able to fill the empty bed if that nurse is in the staff room unless you physically take them from the staff room to the ICU, but they shouldn't be able to leave until the patient has gone. ONe way around this is to require a floating nurse for units above, say, four beds, so that breaks can be covered.

It does require a lot of input and staff but i think it will be alot of fun to design and create, so just to recap.

Intensive Care Unit.

Staffing:- One Anaesthetist (per six beds, any more requires another. They will be in overall charge)
           :- One Nurse per patient. More than two beds requires a seperate Nurse in charge.
           :- One Surgeon, One Researcher and One additional (any speciality) Doctor
           :- One Pharmacist (haven't mentionned him yet but i will)
           :- One Radiographer
           :- One Physiotherapist (haven't mentionned him either but i will!!)
           :- One Administrator/Receptionnist.
(So lot's of people, definintely an investment!!!)
Room Size 6x6
Equipment:- Monitored Bed console, Nurses station, portable XRAY machine, drug room, chair, equipment room.

So there we go. More details can be provided later if necessary/asked for and this is a basic outline of the unit itself.
Alrighty, that's all for now, i hope this explains just what i'm aiming for. Next post i'm going to talk about changes to certain rooms like the pharmacy and the other members of the healthcare team.

Cheers jjjezb

« Last Edit: April 24, 2012, 09:30:20 AM by jjjezb »

jjjezb

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Re: Ideas from a fan and a nurse
« Reply #4 on: April 24, 2012, 02:40:15 PM »
Alrighty gang, hello again and welcome to part 5 of my 'Ideas from a fan and a Nurse' series looking at what i would lurve in my dream Theme Hospital. So today we're going to look at all the additional buildings from the previous game and what i am hoping to see in the next game and so on. There'll be new rooms, new personnel and hopefully cooler way to interact with your hospital.
Ok, so beyond the Diagnosis, Treatment and Clinic room the player has a few other rooms to work with; Research Department, Training, Toilets and the Staff Room. Currently the Research Department does straight research for cures, improvements and occasional auto-autopsy work. As it's staffed by Researchers it has no direct cure function and is often, in my scenarios isolated out of the way in a seperate building. Now whilst i have no reason or need to end the Research Department i would like it back up and be supported by two additional rooms; The Pharmacy and the Pathology Lab.

I know, perhaps the Pharmacy ought to be metionned amongst the treatment rooms, but as it is so depedent on producing drugs and drug research it would be great if the two rooms worked together. The Pharmacy essentially would work to supply relevant other treatment rooms with a supply of medicines but also be a dispensary for patients who are diagnosed and treated without needing ward beds. Patients would hand their prescription in at the reception and wait for their order to be picked up from the pharmacist a few minutes later. In the room there could be a vast cupboard, a cool robotic arm and conveyor belt that packages the drugs and the pharmacists working inside, checking prescriptions and dispensing the medications. It would be awesome. The Research department would do the actual drug research but it would have a corrollary effect on the working of the Pharmacy at large.

Pharmacy:- Staff:- 2 Pharmacists, 1 Receptionist
Room Size:-5x5
Equipment:- Drug cupboard, Sorting machine, Packing robot, Desk, Pick-up window

The next room is the Pathology Lab, this room examines and analyzes all body fluids and tissue and is vital for determining a patients level of function and well-being. Bloods and other body fluids are commonly sent throughout treatment and thus a patient will rack of several Diag Lab costs over their stay. The room is staffed by Researchers and Medical Scientists. The room serves as a complete lab offering the full range of blood tests and as such replaces the the Blood Room and machine. Specimens are entered in through a chute and are tested by the Scientists and the data often checked/interpolated by the Researcher. The research department can also develop equipment and machinery over times improving accuracy and efficiency.

Pathology Lab
Staffing:- 1 Researcher, 2 Medical Scientists.
Room Size 6x6
Equipment:- Specimen Chute, Lab Tables, Specimen Analysers, Computers,

Training Room.
   The Training room will more or less function as it did before with several key differences. For starters all staff will be able to attend training gaining profiency and skills their discipline. The physicians will be able to gain specialization like before with the other professionals gaining their own set of skills so long as there is someone to teach. I think that a four star system of skills levels will be enough for the other staff members with an example hierarchy looking like:

Grade 1/Bronze:-Graduate level employee
Grade 2/Silver:- Experienced employee (+50% skills boost)
Grade 3/Gold:- Specialist Employee (+75% skills boost)
Grade 4/Platinum:- Principal/Chief Employee (+100% boost)

Training rooms can be designated to be segregated into different professionals which will increase turnover but requires a greater number of rooms, one obvious method being one room for the Doctors and another for all other types of employees.
It would be great if our students were able to visit the areas they were training in and observe/take part in care rather than being confined to the room but i'm not too bothered about that. Just getting other people into the training room is cool enough for now! So apart from the that i guess the training room can stay as it is equipment and all.
So apart form that, not much to add on here, as staff rooms are staff rooms and toilets are toilets. I got no complaints about those.

So in summary. The key rooms are; the research department, the Pathology Lab, the Pharmacy and the Training Room. All upfated modern essentials for your hospital.

Cheers! jjjezb