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you need a bit of luck with the staff, i didnt get any decent choices and ended up building a training room so i could get going.
initially i just had a reception desk, GP Office and Fluid Analysis, the only treatment i then needed was Injection Room. This is the first one that i can remember where i haven't had a pharmacy.
you will need janitors for ghosts, this was the other reason i built the training room as i want all janitors collecting ghosts.
don't be scared of the loans either, i often grab the £50k and £100K loans straight away to help build stuff, my training room was about £70k as i needed people trained quickly.
i'm plodding along now, value is about £1.2 million and i have about £400k in the bank (inc loans). I've got 2 of most diagnostics now (fluid, DNA, Psych 3 x GP) and 1 of the main treatments (ward, fracture, injection, doghouse, reamination)
are you increasing the prices for emergencies etc? someone reccomened that to me once and its made a big difference on other hospitals.
One thing I noticed though, is that patients are very slow to turn up. I found it necessary to build a Marketing room (plus get an Assistant with the relevant qualification). Using Marketing made things considerably easier.
You probably also want to be quicker to take out a loan. If you really need to train a staff member, or build a room, don't be too shy about grabbing the cheapest loan.
The first few lots you get will force you to have a long corridor which walking from one side to the other with ghost attack might kill most of patient.
I trend to group GP and diagnosis on one side (minimize walking distance of patient) while the treatment room on the others. Also i recall setting the policy of auto send patient to treatment when diagnosis% around 80 to reduce the need to queue for more diagnosis rooms.
And I'm not sure whether it's bug for me or not there is some small building on the right side which should not cost a lot to expand there. I purchased that lot to place all training/marketing/research and found out that most ghost will spawn in there which reduce the attack on patient so the result is that my patient able to made it to treatment room in higher rate.
Ps. Lastly cheap way of just let marketing team promote pharmacy is how I get pass most of the level easily. (Pharmacy related disease take maximum 1 to none diagnosis room before able to cure them)
no, just make them run
Good Luck, I am now playing sandbox!
Never recruit employees with the "Expensive" trait ("Wants more money"). Never recruit applicants with a level higher than 2 since they cost way too much every month, except for example a level 3 doctor with General Practice 3 and no negative trait. Check new applicants as soon as they are available to recruit the best ones and replace existing ones if necessary, don't wait since new applicants can quickly disappear from the list. Until the hospital is profitable, the best trait to look for is definitely "Cheap" ("Will work for peanuts").
For the first diagnosis room, do not hesitate to build a Mega Scan or a DNA Lab. Even though they are very expensive, they are also the most profitable of the diagnosis rooms. Since almost all patients will go through this unique diagnosis room at the beginning, it will help a lot.
If possible upgrade diagnosis equipment and train employees taking care of diagnosis (especially the GP doctor) before placing any new diagnosis room when the game tells you for example that a patient requires further diagnosis.
Increasing prices also helps a lot, in this hospital I raised all prices to +30% (expect for the GP office). Never take a loan unless you know you won't get out of the red without it and need it to build a treatment room that will be used by many patients.
For the ghosts, they aren't really a big issue. I just trained all my janitors with the skills "Ghost Capture". Only buy new plots when necessary, otherwise your janitors will have more ground to cover which will force you to recruit more.