Clinic hours waiting for test results

[James Blonde]

I think my biggest frustration at the moment is with patients who have been seen and assessed by doctors, sent for tests, and are awaiting test results. If they been tested before 4, or haven't had their results by 5pm, then for the majority of patients, they're not going to get their results before the end of clinic hours, they'll go home unhappy, and you'll never see them again (and in some cases they'll die).

There is also not enough time to reliably get them admitted for either Observation or to a ward, to make sure they stay long enough to get their results / treatment.

I don't think this is a staffing issue - I suspect you could have 100 lab techs, and it would still take as long to turn around the test results?

These scenarios feel unlikely in a real hospital.

There are a number of viable solutions that would fix this logic fault - mix and match of some or all of the following maybe:

- There must be a facility for patients to return (do they??) for results / treatment.
- There should be a facility for existing patients to wait after clinic hours to get their results and the doctor to treat
- There should be a facility for doctors to call patients with results (after hours) and advise to come back in for treatment
- There should be a facility for and end of day review / triage of waiting clinic patients to decide if they should be sent home or admitted, which would allow you to admit patients quickly where it's clear that their symptoms MAY require hospitalisation. This adds a new game puzzle for you to solve around bed management. As part of the triage, you could also add an option for paying extra for a member of staff to stay on to complete any of the patients you don't feel comfortable sending home after the days surgery (but doesn't seem right to admit them). Concequence of that could be poor staff morale, late start next day, more tired, etc.

I half want to say that you could add a reduction in prestige as a concequence of late results / having to keep staff and patients on after hours, etc. but my problem with doing this is it's not the hospitals fault that a patient comes in at 4.30 and test results take time, even with the perfect hospital.

I'm sure there are other options, the mechanics just don't feel right at the moment though?

['Yellow Bird' Steele]

I understand what you mean that there should be a reduction in prestige but I dont know to what extent this already happens in regards to patient ratings as I havent really played to watch stats drop properly enough.

However, think realistically for a moment. If you were to go for a blood test at your local GP/clinic then you will have results within around a week, not an hour.

Also think about game mechanics. If you have a microbial sample, stool sample or a blood test then think of the machines it has to go through the lab. These will be programmed to take up a certain standard amount of time so if the lab receives the samples an hour before closing then that's just tough for the patient, but the tech will still do the test during the day shift (I am unsure if it is passed onto any night shift workers) and will be ready for the patient the next morning. They do actually return to the waiting room for results, you administer treatments and the patient is sent home.

I am not 100% sure how the hospitalization side of things work. I know for Regular, HDU and ICU that it is an overnight stay and discharge in the morning if you have allowed night shift doctors and nurses to administer the treatments throughout the stay (not the case for ICU I believe) but a night stay is guarenteed. Even if you admit them and treat them in an hour for example, they will still stay overnight. The next day you will be notified that they can be sent home and that's that.

Having more tired staff after a hard day, personal incidents, holidays etc, more in depth mechanics sounds really good I agree with you on that, but remember the age of this game. Everything starts off simple and buggy. I am sure the devs will think to implement something of the sort sometime or another.

[James Blonde]

Oh, so patients DO come back the next day if they're still waiting on results? If so, then I'm not so worried!

I absolutely agree with you about waits for results at a GP. In terms of what this facility is though, I don't see the clinic as a GP - I think it's more an emergency (no appointment) clinic. Patients DO have to wait for results and don't get sent home to wait for a week. I'm not sure if it has an equivalent in the UK? a slightly wider scope A&E I guess?

And yes, I agree that results take time - this itself isn't a problem, it's part of the game. I was more concerned that you lost the patient at the end of the day and never saw them again

As for my "triage" suggestion, yep, I'd be happy to accept that any patients I admit have to stay at least overnight, and that would impact on my beds situation.

and the game is great, I love it! More than happy to accept the odd bug, and that development is continuing - It's exciting to see what else might come along!

[Lanfranc]

The problem is that the patients (as I understand how it works) can't do anything else while they wait for their test results. I don't see why they shouldn't be able to go see a doctor in the meantime to get other treatments or to be admitted, instead of just sitting around or even having to go home.

[Voice From Beyond]

Yes, patients do come back for test results and treatment. They also come back if they left before treatment or if they were incorrectly diagnosed. You can speed things up by increasing the number of lab techs AND the equipment they need. Twelve lab techs won't help you process stool samples if they only have one stool analyzer.

Testing is also passed off to the next shift. If you have a lot of testing to do, you probably should have a night shift. If you go into the department layout, you will see a little TV icon in the lab that shows the number of samples waiting to test.

If you're doing the Challenges, you have to minimize the number of patients that leave untreated. The key is as it gets late in the day, start dumping patients into Observation or Hospitalization. Note that patients already waiting for test results cannot be hopitalized until they go see the doctor again.

[AnnieTheWitch]

Speaking of patients waiting for their lab results.... I got one in ICU, he spent about 2 days here and still his blood and stool samples are in progress, I can't choose correct diagnosis and have no idea when will he leave ICU. I wonder if they are lost or what? Does anyone come across such situation?

['Yellow Bird' Steele]

Originally posted by James Blonde:

Oh, so patients DO come back the next day if they're still waiting on results? If so, then I'm not so worried!

Yeh they definitely come back the next day. I was super bummed out when I had a really interesting case on my first game and it was a simple clinic, but I didnt undo the personal control so the next day I was really surprised that I was getting popups about his treatment!

Originally posted by Lanfranc:

The problem is that the patients (as I understand how it works) can't do anything else while they wait for their test results. I don't see why they shouldn't be able to go see a doctor in the meantime to get other treatments or to be admitted, instead of just sitting around or even having to go home.

I have had patients who can get treated while waiting for lab results. If a patient is in pain then I treat them for it while waiting for the blood test to come back and wait to treat them for that.

A way I get around this is to pause my game or at least slow it down, test them, treat them, wait for results to come back to diagnose them, then give them one final treatment for the diagnosis. This allows you to prescribe NSAIDs or make recommendations before they leave after being examined as I believe if you leave them long enough then they will go into the waiting room and wait for the doctor to be free after other patients are attended to.

Originally posted by AnnieTheWitch:

Speaking of patients waiting for their lab results.... I got one in ICU, he spent about 2 days here and still his blood and stool samples are in progress, I can't choose correct diagnosis and have no idea when will he leave ICU. I wonder if they are lost or what? Does anyone come across such situation?

The way I see it is that in the ICU the on-call doctors are not diagnostic doctors but are there to stop the patient from collapsing every 5 minutes.

You may notice that any treatments other than to stop the patient collapsing are not given to the patient. If their heart stops and you need to use a defibrilator then you get to use it. If the patient is in pain then they will lay in their ICU bed in pain or with back pain etc. Put bluntly, bleeding and dying is what the ICU handles.

After a night when the patient is stable then in the morning they will be carted off to the department they came from and put into a HDU room where normal treatments will start again.

[Limskj]

Originally posted by Steele:

The way I see it is that in the ICU the on-call doctors are not diagnostic doctors but are there to stop the patient from collapsing every 5 minutes.

You may notice that any treatments other than to stop the patient collapsing are not given to the patient. If their heart stops and you need to use a defibrilator then you get to use it. If the patient is in pain then they will lay in their ICU bed in pain or with back pain etc. Put bluntly, bleeding and dying is what the ICU handles.

After a night when the patient is stable then in the morning they will be carted off to the department they came from and put into a HDU room where normal treatments will start again.

This. I can't tell you how many people here have the wrong idea of what ICU is really for. Although, you can order most treatments in ICU.

[Paul]

How to change clinic opening times in Project Hospital :) https://youtu.be/6iHHiKonWFw