State of the Game and Notes from the Modding Community

[Butchattending]

I’m going to start off by saying this is going to be quite a long post. I want to talk about the current state of the game and relay some of the thoughts and conversations we’ve been having in the modding community and how we’d like the game to move forward.

Firstly, I’m going to make a very bold statement. This is easily, without a doubt my favorite game of all time. I used to play the hell out of Theme Hospital as a kid and I remember thinking to myself “Damn, if only some game making company would make a game like this but based on real life medicine”. 20 years later you made that game for us and I got to play it as a real doctor. The realism and simulation is unprecedented in a video game and it’s very clear to me (and a bunch of other people who have been modding the hell out of your game!) that the potential that this gem of a hospital simulation has, is huge.

As a small game developing studio, one of the best decisions you made was to make this game very easy and straight forward to mod. The sheer amount of work and effort that some of the modders are pouring into this game is really amazing to see. With your limited manpower and resources at Oxymoron, it only makes sense for you to continue to rely on this passionate modding community to help grow and continue to improve the game. Having said all this, we implore you to focus your efforts on adding new game systems and mechanics in future DLC as opposed to new assets, departments and diagnoses. With the current modding capabilities we have at our disposal, a small dedicated team of modders has already cranked out hundreds of new symptoms, examinations and conditions all with unique icons. This is great for the health and longevity of the game (which I’m sure you know) and so it is extremely important for you to continue to focus on giving us more “moddable” things in the game.

Now to critic the state of the game. Obviously we’ve come a very, very long way since release in terms of optimization and overall functionality of all the game systems. I took a long break from the game and now that I’m back months later, the improvement is very noticeable. Being able to change where your ambulances drop off patients is such a game changer. Pathfinding and character AI is noticeably better. But there are still some obvious blemishes that take away from the overall simulation. The handover process where the night shift gives way to the day shift is border line comical. Seeing hundreds of employees just vacate the building all at the same time like there’s a bomb threat is just so jarring to see. So many patients in critical condition are just left on Trauma Center tables and in their wards unattended while they collapse. This is highly unrealistic and even game breaking. We desperatey need a new handover system where staff only leave their workstation when the next shift is already present in the building and ready to relieve them. Staff scheduling and micro management is one of those things that’s been requested over and over again; please make it happen!

There’s been a lot of brain storming and discussion going on in the modding community with regards to how we can improve the management aspect of the game. At the moment, staff skill level and specialization level don’t have a very big impact on the game. Yes, having a low diagnosis skill will lead to the doctor misdiagnosing patients more often. Having a high surgery skill level will lead to less surgery complications post op. But the effects of these skill levels don’t really influence my decision making as a player nearly as much as they should when it comes to hiring doctors and nurses. I want to feel like there’s a huge difference between a 27 year old intern fresh out of medical school and a 71 year old specialist whose been practicing for 40 + years! The solution: allow examinations and treatments (not just surgeries) to result in complications. Make the doctor/technician’s skill level have a huge impact on the risk of complications and more importantly.... make all these parameters very moddable! If an intern or junior resident attempts to peform a colonoscopy in real life I’m betting you money that patient’s large bowel is getting punctured and they’re going into surgery. A senior gastroenterologist (specialist) can perform a colonscopy blindfolded. This is the kind of simulation I feel the game is really missing. If examinations and treatments had the possibility of leading to complications (just like how surgeries do right now) we could REALLY make things interesting.

Recently we’ve been talking about modding the game in such a way to make money much more meaningful. In the late game, money is literally a non factor and eventually your entire hospital is run by top of the line elite doctors and nurses. We want Project Hospital to put us in situations where we have to really make conscious decisions about who we hire and how we spend our money. Do we pay less and hire lots of residents prone to mistakes? Or do we fork out the cash and hire world class staff at the risk of going bankrupt? Modding salaries and making money more difficult to come by is possible at the moment; but the staff management aspect of the game is really lacking. With all these things in mind, I bring us back to the original point of this post: the best thing you can do for this game is to open up the code a little bit and allow more things to be moddable. There are some absolutely brilliant ideas and projects that we the modders want to realize but the current hardcoded limitations slow us down. There’s a long modder’s wishlist in the Modder’s Corner that we’ll be updating regularly. It would mean a lot if you acknowledged these requests.

All in all the game is doing great right now. The reviews on steam have been excellent ever since release and more people are discovering the game. Thank you for doing such a wonderful job and continuing to support the game almost 2 years after release. Stay safe and best of luck with the new DLC. We can’t wait to play it!

[roman.oxymorondeveloper]

Hi, thanks a lot for the feedback ... I've made some notes about your requests and will discuss it with programmers, but I can't promise anything for now

[Fading Qualiaspecialist]

I'll strongly second Butch on this one. This game is absolutely incredible, and it has been a joy to follow its development all the way back to the old forums. Seeing what you all were working on and having to wait a year to begin testing the early versions was torture. I've been looking for this game for years and couldn't wait to get my hands on it! And since then, every decision the dev team has made for this game has, in my opinion, been the right one. I LOVE how this game continues to grow and develop.

That being said, I would also love to see the management system fleshed out a little bit further, either through a DLC or the modding community. What Butch suggests sounds great! The game is amazing, and I'm excited to see where it continues to go.

[user947fellow]

I agree with Butch. I love this game, spent so many hours playing it, and with some adjustments, this game is going to be perfect.

[MedJetspecialist]

Roman: he's so kind and brutally honest at the same time.

I am just longing for some kind of staff progression. Aging out retirement. bring in the new folks and get 'em rolling.
Oh, and the shift changeover, ohhh myyy; I worked at a hospital and I'd be leaving the place pronto and running for my dear life if that's how it took place. I hope it can be changed. Maybe a third shift (float position, kind of like a swing) even if it's only for critical response depts.

[quirkycatresident]

I too love this game. While I really like a bit of realism we have to remember this is still a game and gameplay has to come before realism.

[MedJetspecialist]

I too love this game. While I really like a bit of realism we have to remember this is still a game and gameplay has to come before realism.

Not necessarily, and certainly not consistently.

[quirkycatresident]

Just a suggestion: add more limitations to what examinations juniors can perform. This would force players to add at least one senior doctor to each team.
Also, only allow more senior doctors to be HoDs. Or have the experience of the doctor have a more significant impact.

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