I'm sure there are other options, the mechanics just don't feel right at the moment though? 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 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. Concequence of that could be poor staff morale, late start next day, more tired, etc. 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). This adds a new game puzzle for you to solve around bed management. 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. 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 existing patients to wait after clinic hours to get their results and the doctor to treat There must be a facility for patients to return (do they?) for results / treatment. There are a number of viable solutions that would fix this logic fault - mix and match of some or all of the following maybe: These scenarios feel unlikely in a real hospital. 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?
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. 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). 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.
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