Prestige always low

[Sunny]

Im am really struggling with this game, I have so many decorations, most expensive pcs, chairs, clean shoe doctors, loads of decors, like 4 vending machines and water in each waiting room and prestige is still only 2 stars.

Radiology is almost always 0-1. When I took a look at the meters,
staff say they are exposed to weather?
and are unnattended?
and ugly ?
but what does that mean? the whole hospital is walled in, even tried adding a second floor but no change?

what fixes these issues? because i always become broke because i get hardly any patients.

thanks

[moa]

"staff say they are exposed to weather? ... the whole hospital is walled in, even tried adding a second floor but no change?"
means the building has a gap in the wall somewhere, maybe a corner hidden behind another wall? Rotating the map may help. If you cant find it, maybe people have to leave a building to get for another one? don't know if this also triggers the moodlet, if so you may have to create a corridor and connect the buildings.

" and are unnattended?"
Each department has a doctor as supervisor. The trait with megaphone symbol gives a bonus. For departments that do not have a doctor (like labs and radiology) they get the same supervisor as the emergency department.

"and ugly ?"
There are some dirty spots on the ground, an additional janitor may help, or make a new janitor room exclusively for the department that has many dirty spots. Could also be that some floor is not assigned as a room. Janitors clean only rooms. First they do rooms in there own department and then help out in other departments.

For decorations I found that 1 - 2 decor element (posters, lamps, tee pot on desk, flowers, wall clock, trash can...) per room give a neutral bonus and 3 elements give a positive bonus.

[Sunny]

Originally posted by moa:

"staff say they are exposed to weather? ... the whole hospital is walled in, even tried adding a second floor but no change?"
means the building has a gap in the wall somewhere, maybe a corner hidden behind another wall? Rotating the map may help. If you cant find it, maybe people have to leave a building to get for another one? don't know if this also triggers the moodlet, if so you may have to create a corridor and connect the buildings.

" and are unnattended?"
Each department has a doctor as supervisor. The trait with megaphone symbol gives a bonus. For departments that do not have a doctor (like labs and radiology) they get the same supervisor as the emergency department.

"and ugly ?"
There are some dirty spots on the ground, an additional janitor may help, or make a new janitor room exclusively for the department that has many dirty spots. Could also be that some floor is not assigned as a room. Janitors clean only rooms. First they do rooms in there own department and then help out in other departments.

For decorations I found that 1 - 2 decor element (posters, lamps, tee pot on desk, flowers, wall clock, trash can...) per room give a neutral bonus and 3 elements give a positive bonus.

thankyou for your help. Hmm i guess ill need to rotate the map more often to be sure there are no holes, it was all closed in for all departments i thought.

Im not even sure how to add a supervisor? That could be what im missing

I make sure there are enough janitors, i hire no dirty feet staff so its always looking clean

[Sound Zero]

It may be easiest to find a wall gap in build mode. If you click the wall tool, it will set everything a bit dimmer except for walls so you an see better.

To set a supervisor, open your department management tab, the gear icon. Then click the department from your active departments at the bottom of the screen. You should see UI box on the top left that shows the various clinic rooms you can build, such as an office or a waiting room.

At the bottom of that UI panel, you will see a Big plus on the lower right side. Can't really miss it. If you click that, it will open a list of doctors who work in that department, and clicking one will put them in charge.

If you choose one that has the "good boss" perk, which looks like a Megaphone symbol on their card, they add an additional point of satisfaction to your employees in that department. However, you don't need to find a good boss perk, any employee can be chosen.

Ugly environment really has nothing to do with dirt. It has to do with decorations. A room needs some posters, plants or other such items spread about it. If it doesn't have these, anyone in it will think it's ugly, because it's just plain walls.

When in construction mode, choose the decorations tab. Anything in that tab will add beauty to a room. Things like small tables with flowers, posters, plants, signs, etc.

The more realistic a room looks, the better for the patients and staff.

If a room is dirty, that has it's own modifier. You will see "dirty" as one of the negatives from a patient or staff member. It will affect prestige, so make sure you have enough janitors. In larger hospitals, make use of the Cleaning Manager to make sure you janitors are giving the right coverage. You need cleaning closets for each department and on each floor. If a janitor has to walk a long way to get to a mess, they may have to stop and fill needs before ever making it there and it will stay dirty a long time.

Prestige is handled two ways in the game.

Patients and Staff.

For Staff, they have needs like patients. If a staff member is unhappy, they will have lower stars. You can see that by hovering over the stars under their portrait on their card. It will list the good and bad they have experienced.

Some things are out of your control, such as dealing with an annoying patient. Or if the employee has depression. But with an efficient hospital, even a depressed employee can have a good work day.

Make sure you have enough staff to cover a shift so that they can all get a lunch break and fill their needs.. Coffee machines in the cafeteria or common room greatly helps their energy during the day.

Make sure you common rooms and cafeterias are close enough so that they don't spend a long time getting to one.

Have plenty of restroom stalls available. If you have an empty space and don't know what to build, a restroom is always a good choice. Even one toilet in a closet will assist you.

Staff that work with more than 3 stars work faster and make more accurate decisions. Anytime one of their needs drops to two stars, they will slow down. The more that hit two stars, the slower they become. You can put your cursor on the individual needs to see it's effects and how to help them.

Patients want to get in, be diagnosed quickly and get out. The longer they are in the hospital, the more they will complain. You can expect every patient to arrive around 3 stars. A nice environment, from having decorations, will increase their mood right away.

The more efficient your doctors, the faster and more accurately they can diagnose your patients. Early on getting the best doctors can be tough due to costs, but as you progress, find the best doctors or train those you have. You want experts.

You can get by without them for some time, so don't feel rushed, but if your prestige is consistently low, check your statistics to see what the biggest complaints are.

At the bottom of the UI there is a department stat button, first one on the left, It looks like a triangle with a circle on each point. It's next to the insurance company list, and can even be reached from that tab.

On it you will find a lot of helpful info. How many rooms are running at critical status, and of course, what the complaints are. By both staff and patients.

This will help you correct issues they are having in that department.

Long wait is a huge one, as once they get that modifier, you can't get rid of it. Long waits happen if they have to walk a long distance to be treated or for testing. If the lab is slow or a doctor made them wait a long time.

Those can be helped with happier staff, and make sure you have enough staff and equipment. If your lab is running slow, hiring more technicians may help, but they can't all use the same equipment at the same time, so make sure you have enough. For example, the Hematology lab might have only one set of glassware. So only one tech can run a test at a time. That means the other is just waiting and not really helping.

A good marker for this is to have one device for every two staff. This makes sure you always have enough equipment. But watch your people, see what they use the most. If they are using the microscope a lot, have more of those. If they aren't using the RIA often, then having less won't hurt you.

Make sure your patients can fill their needs! A vending machine is pricey, and doesn't really make you money. It's $5 when they use it, but a patient who is hungry will want to eat. If they are in the hospital, they get fed by the nurses. If not, vending is your only option. Have A LOT OF WATER DISPENSERS. A LOT!

Water is used by everyone, and outside offices, hospital rooms, and restrooms every room should have one. Every waiting room, corridor, lounge, even labs, should have one. Your staff and patients will wander off to find one, and they do this a few times a day. If they have to go far, it will slow things down considerably. Make sure they have easy access to water. Always.

The UI prestige monitor on your screen at the bottom shows which departments have the lowest ratings when you hover your cursor over it. Use it to see which departments are having issues.

Check for critical rooms, meaning they are having a hard time seeing all patients in a shift. You may need more staff or more rooms of that type. You can check for this in management mode, the gear icon on the left top panel, then each room will show the day shift and night shift "workload". A room that says high is getting close to max, a critical means they are struggling.

See if you can do anything to help it, or build another room of that type.

Lastly, watch for negative perks on your staff. A doctor with a trait like depressed will start with a two point hit to their Satisfaction every day. A well run hospital won't notice, but if things start to go poorly, they notice it first.

Traits also like long commute can hurt. That person will likely be hours late every day. Every hour late there is work not being done. Alcoholic and mean are two perks you don't want as well.

Many of the other perks are negative but can be worked around. Perks like Hedonist aren't so bad. That person will take twice as long to eat lunch. But otherwise it has no negative affect.

Hopefully this helps you start to understand how to check and work on your prestige as you play. There is a lot of depth to the management of the hospital, and you will learn as you go what works best.

As you've done, feel free to ask any questions you have here and I will gladly answer you when I get a chance.

Cheers.

[Sarsgamer]

Originally posted by Sunny:

Originally posted by moa:

"staff say they are exposed to weather? ... the whole hospital is walled in, even tried adding a second floor but no change?"
means the building has a gap in the wall somewhere, maybe a corner hidden behind another wall? Rotating the map may help. If you cant find it, maybe people have to leave a building to get for another one? don't know if this also triggers the moodlet, if so you may have to create a corridor and connect the buildings.

" and are unnattended?"
Each department has a doctor as supervisor. The trait with megaphone symbol gives a bonus. For departments that do not have a doctor (like labs and radiology) they get the same supervisor as the emergency department.

"and ugly ?"
There are some dirty spots on the ground, an additional janitor may help, or make a new janitor room exclusively for the department that has many dirty spots. Could also be that some floor is not assigned as a room. Janitors clean only rooms. First they do rooms in there own department and then help out in other departments.

For decorations I found that 1 - 2 decor element (posters, lamps, tee pot on desk, flowers, wall clock, trash can...) per room give a neutral bonus and 3 elements give a positive bonus.

thankyou for your help. Hmm i guess ill need to rotate the map more often to be sure there are no holes, it was all closed in for all departments i thought.

Im not even sure how to add a supervisor? That could be what im missing

I make sure there are enough janitors, i hire no dirty feet staff so its always looking clean

Supervisors give a pretty big boost. You can add them by clicking on the department, in build mode and in the left window on the bottom right corner there's a supervisor option. I think it works better to have day staff as your supervisor and also if you have one with "good boss" perk that's the best option - i think "good boss" is the only trait that affects supervisors.

I didn't notice the supervisor option at first either and once i did it had a pretty big impact on rating.

Also in department build mode you can see the staff and patients most common + or -. That's usually enough to judge where you might need improvement. You can look at staff and patients individually as well by clicking on them and in the top right hover your mouse over the rating text, or overall sanctification - I forget how it's worded in game.

Also also - if there is a high amount of "dirty" negatives it doesn't always mean that department. Could be entry way, lab or radiology rooms too. If many departments have a lot of dirty negatives it's likely one of those departments that janitors aren't being kept up on. Or even training rooms or cafeterias if you have that DLC.

[Sunny]

Originally posted by Ghostmane:

It may be easiest to find a wall gap in build mode. If you click the wall tool, it will set everything a bit dimmer except for walls so you an see better.

To set a supervisor, open your department management tab, the gear icon. Then click the department from your active departments at the bottom of the screen. You should see UI box on the top left that shows the various clinic rooms you can build, such as an office or a waiting room.

At the bottom of that UI panel, you will see a Big plus on the lower right side. Can't really miss it. If you click that, it will open a list of doctors who work in that department, and clicking one will put them in charge.

If you choose one that has the "good boss" perk, which looks like a Megaphone symbol on their card, they add an additional point of satisfaction to your employees in that department. However, you don't need to find a good boss perk, any employee can be chosen.

Ugly environment really has nothing to do with dirt. It has to do with decorations. A room needs some posters, plants or other such items spread about it. If it doesn't have these, anyone in it will think it's ugly, because it's just plain walls.

When in construction mode, choose the decorations tab. Anything in that tab will add beauty to a room. Things like small tables with flowers, posters, plants, signs, etc.

The more realistic a room looks, the better for the patients and staff.

If a room is dirty, that has it's own modifier. You will see "dirty" as one of the negatives from a patient or staff member. It will affect prestige, so make sure you have enough janitors. In larger hospitals, make use of the Cleaning Manager to make sure you janitors are giving the right coverage. You need cleaning closets for each department and on each floor. If a janitor has to walk a long way to get to a mess, they may have to stop and fill needs before ever making it there and it will stay dirty a long time.

Prestige is handled two ways in the game.

Patients and Staff.

For Staff, they have needs like patients. If a staff member is unhappy, they will have lower stars. You can see that by hovering over the stars under their portrait on their card. It will list the good and bad they have experienced.

Some things are out of your control, such as dealing with an annoying patient. Or if the employee has depression. But with an efficient hospital, even a depressed employee can have a good work day.

Make sure you have enough staff to cover a shift so that they can all get a lunch break and fill their needs.. Coffee machines in the cafeteria or common room greatly helps their energy during the day.

Make sure you common rooms and cafeterias are close enough so that they don't spend a long time getting to one.

Have plenty of restroom stalls available. If you have an empty space and don't know what to build, a restroom is always a good choice. Even one toilet in a closet will assist you.

Staff that work with more than 3 stars work faster and make more accurate decisions. Anytime one of their needs drops to two stars, they will slow down. The more that hit two stars, the slower they become. You can put your cursor on the individual needs to see it's effects and how to help them.

Patients want to get in, be diagnosed quickly and get out. The longer they are in the hospital, the more they will complain. You can expect every patient to arrive around 3 stars. A nice environment, from having decorations, will increase their mood right away.

The more efficient your doctors, the faster and more accurately they can diagnose your patients. Early on getting the best doctors can be tough due to costs, but as you progress, find the best doctors or train those you have. You want experts.

You can get by without them for some time, so don't feel rushed, but if your prestige is consistently low, check your statistics to see what the biggest complaints are.

At the bottom of the UI there is a department stat button, first one on the left, It looks like a triangle with a circle on each point. It's next to the insurance company list, and can even be reached from that tab.

On it you will find a lot of helpful info. How many rooms are running at critical status, and of course, what the complaints are. By both staff and patients.

This will help you correct issues they are having in that department.

Long wait is a huge one, as once they get that modifier, you can't get rid of it. Long waits happen if they have to walk a long distance to be treated or for testing. If the lab is slow or a doctor made them wait a long time.

Those can be helped with happier staff, and make sure you have enough staff and equipment. If your lab is running slow, hiring more technicians may help, but they can't all use the same equipment at the same time, so make sure you have enough. For example, the Hematology lab might have only one set of glassware. So only one tech can run a test at a time. That means the other is just waiting and not really helping.

A good marker for this is to have one device for every two staff. This makes sure you always have enough equipment. But watch your people, see what they use the most. If they are using the microscope a lot, have more of those. If they aren't using the RIA often, then having less won't hurt you.

Make sure your patients can fill their needs! A vending machine is pricey, and doesn't really make you money. It's $5 when they use it, but a patient who is hungry will want to eat. If they are in the hospital, they get fed by the nurses. If not, vending is your only option. Have A LOT OF WATER DISPENSERS. A LOT!

Water is used by everyone, and outside offices, hospital rooms, and restrooms every room should have one. Every waiting room, corridor, lounge, even labs, should have one. Your staff and patients will wander off to find one, and they do this a few times a day. If they have to go far, it will slow things down considerably. Make sure they have easy access to water. Always.

The UI prestige monitor on your screen at the bottom shows which departments have the lowest ratings when you hover your cursor over it. Use it to see which departments are having issues.

Check for critical rooms, meaning they are having a hard time seeing all patients in a shift. You may need more staff or more rooms of that type. You can check for this in management mode, the gear icon on the left top panel, then each room will show the day shift and night shift "workload". A room that says high is getting close to max, a critical means they are struggling.

See if you can do anything to help it, or build another room of that type.

Lastly, watch for negative perks on your staff. A doctor with a trait like depressed will start with a two point hit to their Satisfaction every day. A well run hospital won't notice, but if things start to go poorly, they notice it first.

Traits also like long commute can hurt. That person will likely be hours late every day. Every hour late there is work not being done. Alcoholic and mean are two perks you don't want as well.

Many of the other perks are negative but can be worked around. Perks like Hedonist aren't so bad. That person will take twice as long to eat lunch. But otherwise it has no negative affect.

Hopefully this helps you start to understand how to check and work on your prestige as you play. There is a lot of depth to the management of the hospital, and you will learn as you go what works best.

As you've done, feel free to ask any questions you have here and I will gladly answer you when I get a chance.

Cheers.

Wow that an insane amount of information. thankyou so much for typing that out, i was constantly sitting at 50% patient intake and i was just going broke everygame, having to rely on loans to build new departments. decorations and venders/water i had everywhere, I think the problem was i was hiring the best skilled staff, not their perks, i just avoided dirty feet. I will take your tips here and see how i go :)

my radiology was always at 0 stars for some reason so ill see why.

[eXeZ|Gamer433]

Originally posted by Ghostmane:

A room needs some posters, plants or other such items spread about it. If it doesn't have these, anyone in it will think it's ugly, because it's just plain walls.

When in construction mode, choose the decorations tab. Anything in that tab will add beauty to a room. Things like small tables with flowers, posters, plants, signs, etc.

The more realistic a room looks, the better for the patients and staff.

Decorations are a bad joke in this game. Even you have all DLCs, there are not many variations and why the hell can we only chose 5 different colors?!?

But most, what me cracks up, is, that every lousy poster needs a free spot infront of it. So, you cant place them above chairs or tables. Why?!?
Why is a damn poster blocking the access to a machine or to a chair? Thats so ridiculous!

[Sound Zero]

Originally posted by eXeZ|Gamer433:

Originally posted by Ghostmane:

A room needs some posters, plants or other such items spread about it. If it doesn't have these, anyone in it will think it's ugly, because it's just plain walls.

When in construction mode, choose the decorations tab. Anything in that tab will add beauty to a room. Things like small tables with flowers, posters, plants, signs, etc.

The more realistic a room looks, the better for the patients and staff.

Decorations are a bad joke in this game. Even you have all DLCs, there are not many variations and why the hell can we only chose 5 different colors?!?

But most, what me cracks up, is, that every lousy poster needs a free spot infront of it. So, you cant place them above chairs or tables. Why?!?
Why is a damn poster blocking the access to a machine or to a chair? Thats so ridiculous!

Actually, that's not exactly correct.

Posters have two functions. One is as a decoration,the other is as entertainment.

If a patient gets bored, they can go over and read the poster, that will satisfy the boredom and give them entertained.

You can have the poster on the wall, even above a chair or plant that turns it "yellow", and still get the decoration credit.

If a patient can't interact with it, then its decoration only.

You can test this yourself, just put some on the walls where no one can actually use them, they will be yellow in build mode, then check your staff/patients. You'll see they still get the nice environment trait.

If you look at the prefabs made by the developers, you will a lot of these rooms with yellow decor items for this reason.

Try it. You can make rooms a lot smaller this way. In a clinic office, the patient isn't going to interact with the posters, so they are decor only anyway. May as well drop a plant in front and get double the decor bonus for one space. Or put the chair in front of it.

But in waiting rooms, or places where a patient will sit for a while, you might wish to avoid doing this because they can use them to satisfy the boredom trait.

There are some specific places you can't put deoor on the wall because it may interfere with a required interactable object, but the majority of decor items can sit behind other items and still provide the bonus.

Red means it can't go here. Yellow means it won't be "usable". Decor doesn't have to be usable to get the environment bonus.

[eXeZ|Gamer433]

Originally posted by Ghostmane:

Actually, that's not exactly correct.

Posters have two functions. One is as a decoration,the other is as entertainment.

If a patient gets bored, they can go over and read the poster, that will satisfy the boredom and give them entertained.

You can have the poster on the wall, even above a chair or plant that turns it "yellow", and still get the decoration credit.

If a patient can't interact with it, then its decoration only.

Yah, indeed, you are right. thank you for clarifying.
I saw this all the time myself, but when you get a message with "it can be placed here, but something else will be blocked", then you are worried, that something more important is not usable anymore. I never risked that.

Originally posted by Ghostmane:

Try it. You can make rooms a lot smaller this way. [...]
But in waiting rooms, or places where a patient will sit for a while, you might wish to avoid doing this because they can use them to satisfy the boredom trait.

I build the rooms small, in most way, because, I dont see any logic in building big rooms. It cost more money and the people has to walk a lot more, but there is no bonus (of course, every important thing is placed and decoration is always enough to get the trait "nice enviroment" and yes, I know, more space = more possible work stations, but often its better to build smaller rooms).

This means also, that I have, normally, no space for this poster, so that the patients can read them. Okay, now I know how to use them correctly, BUT why are they not readable, when they are placed above a desk, plant, bin or a chair?! And why does bins have no effect (except decoration)?

Originally posted by Ghostmane:

[...]Yellow means it won't be "usable".

Then there should be a note, that THIS item is not usable, not "something else will not be usable" (at least, in my language there is such weird note).

Nevertheless, there are too few decoration items in this game.