Illnesses, diagnosis, traits, tips and more...

Introduction

This is a compilation of results from experiments that I conducted with Leamia (on Reddit) and others.

You can freely use data from this guide for your websites, wiki, etc...

If you spot any issue, please let me know in the comments. :)

General Tips - Part 1

1) It's probably the most important of the tips: at the start of any mission or when you start having queues at your GP offices, click on the dollar icon at the bottom left of the screen, go in the "Overview" menu and select the "Policy" tab. Make sure to activate "Fast-Track Treatment Decision", it makes patients directly go to treatment once the diagnosis threshold is reached without losing time returning to the GP office. Note that this is not a global setting, you have to check the policy tab individually for every mission.

2) A rule to follow to have a good hospital is to build GP offices close to the reception desks since all new patients go to the GPs first. Diagnosis rooms should be close to the GP offices since patients will go there next then potentially come back to GP and maybe even return to another diagnosis room after, etc...

Finally, since treatment rooms are the last stop for all patients, you can keep them further. However, this doesn't mean that you should build them on the other side of the map. Keep them close and move them further when you need to make space for more GP or diagnosis rooms. If possible build the treatment rooms close to the helipad to lose less time during emergencies.3) When you go in the "Staff" management screen, there is a button at the bottom called "Jobs assignment". From there you can untick boxes for room types where you don't want an employee to work. For better efficiency, this is highly recommended to specialize staff and only make them work in rooms where their skills are useful. There is no reason for an employee with treatment skills to work in a diagnosis room. If there aren't many queues at treatment rooms, it's better to make those treatment specialists work in multiple treatment rooms instead of recruiting one employee per room who will just do nothing 70% of the time while waiting for patients.

4) When Happiness of a medical employee is above 80%, they gain the buff called "Happy" which increases their treatment and diagnosis skill by 10% but also move speed by 10% even though it's not written in the buff description. A happy employee taking care of a patient also gives them +5% happiness. When Energy of an employee is above 80%, they gain the buff called "Energised" which increases their speed, treatment, diagnosis and research skill by 10%. They instantly lose those buffs when happiness/energy goes under 80%. A table with all buffs and debuffs given to staff when the energy and happiness are above or below a threshold can be found at the tip 28.5) When employees are training to get a skill, they slowly gain energy over time. Try to use that to your advantage and not waste that extra energy by sending them to the training room when their energy is between 20 and 60%.6) Bonuses provided by items like "+1% Training Speed" stack. With enough training boost items and/or teaching/learning trait and qualification, it's possible to have a training duration of less than 1 day:

https://www.youtube.com/watch?v=hSeU_m1PtGI&feature=youtu.be

However, there is no point aiming such a short time since it requires too much effort to set-up everything. Lowering the duration below 4 or 5 days requires a ton of boost items. If you have the extra money, it's still a good idea to add boosting items to reduce the training duration since missing one important employee during a long time can be bad.7) Just like the Motivation skill, Caffeine Buzz (from Coffee Maker item) only increases move speed. The buff boosts the speed to 200 which seems to be the max and makes employees run. However, it's extremely short and only lasts 20 seconds... Nothing too crazy. Note that Energy Buzz (from Energy Drinks Machine) has the same effect but lasts 30 seconds.

Also it seems like employees will only drink a coffee if they are thirsty (when thirst is at least 40% depleted). And if there is an endless flow of patients they will never take the time to drink at all (they will only play the cosmetic animation making them look at the coffee machine) !8) When an employee is working, 1 energy is lost every ~6.6 seconds. The energy should take around 11 minutes to go from 100 to 0 energy.

For an employee with the Stamina qualification, 1 energy is lost every ~8.9 seconds. Therefore, it takes around 14 minutes 48 sec for the energy to go from 100 to 0. By default, an employee works 134 in-game days before taking a break. With Stamina Training, an employee works 178 days before taking a break, it's 44 days more which can be very useful for surgeons for example.

Note also that an employee with the Stamina qualification seems to recover energy more slowly. ~11 energy every 20 seconds against ~15 energy for others without Stamina qualification. Generally, it's not an issue since energy tends to be full before the end of the break if you didn't change the break policy.9) Plants look good and the attractiveness bonus they bring is nice. However, except for cosmetic purpose it's better to rely on other objects like posters, paintings, awards to increase attractiveness of an area. Since those items don't need watering, your janitors can focus on other more important tasks. Plants can actually have a negative attractiveness effect if your janitors don't manage to water them all quickly enough. That's also why they are less reliable.10) When you increase prices, you can see that some patients will refuse to pay. One of the most important factors affecting the chance to pay is the happiness of the patient, another factor in treatment rooms is if a cure fails or succeeds. Overall, just keep in mind that an unhappy patient will be less willing to pay higher prices. The happiness threshold defining if they will pay or not seems to depend on the illness and prices. In most cases, they will pay any price (even +100%) when their happiness is above 50% during the payment process. However, if the treatment fails they will need more happiness to be willing to pay, with +100% prices the threshold seems to be around 55-65% happiness depending on the illness.

When patients pay higher prices, they lose happiness. For example, getting diagnosed in the mega scan room with prices at +100% can make the patient lose around 25% happiness. That's why I recommend not increasing prices for GP offices and even for diagnosis rooms. Patients will be more happy when entering the treatment room and be more likely to pay increased prices there where it's the most profitable.11) It's usually recommended to avoid using benches. The main reason is that they make patients take more time to enter a room when it's their turn. Without any bench, patients are all standing in line right next to the door and as long as they stay there, they will very quickly enter the room. While technically standing patients take more space in hallways than sitting patients, benches can also create some chaotic situations especially if there aren't enough for everyone. Sometimes patients seem to randomly stand-up and switch places which is annoying.

However, benches have a benefit, they reduce the happiness loss over time of sitting patients (they don't seem to affect the needs or health gauges at all). I usually do not buy benches but if you intend to use them I recommend making sure there are enough for every patients, or you should probably not use them at all. Having some people standing and others using benches while queuing to enter the same room can make people have trouble moving through the hallway depending on the layout.

General Tips - Part 2

12) Room prestige level increases happiness over time of staff in the room.

At level 1: it provides no benefit.

At level 2: it provides the buff "Nice Room" => +5% happiness

At level 3: it provides the buff "Good Room" => +10% happiness

At level 4: it provides the buff "Amazing Room!" => +20% happiness

At level 5: it provides the buff "Outstanding Room!" => +30% happiness

Employees will gain happiness as long as the bonus outweighs their debuffs that negatively affect happiness (like "Underpaid", "Desperate for the Toilet", "Very Thirsty", etc...). It's very easy to keep an employee working in a level 5 room happy especially if objects increasing attractiveness are near their work station or desk. Note that prestige level doesn't affect patients in the same way, however the effect is still very powerful for patients too because it gives a happiness boost to them when they are taken care of (except for the reception room since patients are outside).

At level 1: +5% happiness is instantly given to patients when taking care of them

At level 2: +9% happiness is instantly given to patients when taking care of them

At level 3: +14% happiness is instantly given to patients when taking care of them

At level 4: +17% happiness is instantly given to patients when taking care of them

At level 5: +20% happiness is instantly given to patients when taking care of them

Regarding items increasing attractiveness, they can provide the buff "Attractive Environment" which can boost happiness up to 25%. Unlike room prestige this bonus also directly affects patients by giving them a boost of up to 11% happiness p/month.

One of the best items to increase room prestige is definitely the Gold Star Award, it's small so you can place many on walls. It increases room prestige a lot, boosts attractiveness and doesn't need maintenance. 200 Kudosh are necessary to unlock it but is definitely worth it if your play style is more about optimizing things than making your rooms look pretty...13) There is no intrinsic benefit to build a room bigger than the minimal size (except in the case of wards to place more beds). It could even have a negative effect if a patient/doctor has to walk more to start diagnosing/curing so make sure to place the working station close to the door. That said, bigger rooms can be useful to place more Medicine Cabinets to boost diagnosis/treatment or Encyclopaedia Bookshelves II and Anatomy Models in training rooms.14) Make sure to have large corridors of 2 tiles to avoid congestion. 1 tile hallways can make patients/staff have trouble moving from one point to another, that's why they should be avoided when possible. If you have some narrow corridors, at least don't put objects on the way.15) It's possible to precisely rotate and move objects (without having it snap to the "grid") by holding left Ctrl key. You can also instantly create a copy of an item already placed in the hospital by holding the left Ctrl key before clicking on it.16) Skills of nurses working in surgery doesn't affect the cure chance, only skills of the doctor matter in this room. So either assign a level 1 nurse to work there and don't bother with promotion/training, or just set surgery as an extra assignment for any of your nurses that is not too busy already.17) When a training is in progress and you forgot or want to train additional people, just pick and drop them in the room. As long as they have an available training slot and an available trainee desk, they will do the current training too. Their training fee will be automatically paid as soon as they are dropped in the room.18) Research projects are tied to the account and not just to the hospital where they have been completed. This means that if you don't want to bother with research in all hospitals, you can complete all research projects you need in a previous hospital (Mitton University being the best hospital for that). It can be assimilated to an "exploit" since it makes the game much easier than it is when you don't have to build a research room in every hospital and recruit researchers. It's up to you how you want to play anyway.19) This is something I learned quite late but you can instantly pick-up an employee from the staff list directly with a right-click. This way, you avoid making the camera automatically move to the employee when you first left-click to select the employee before clicking on the Pick up button.20) It's not written in their descriptions but "Server" and "Super Computer" items also increase temperature around them (less than small radiators). So make sure to display the temperature overlay when using those items to avoid turning a room into an oven.21) The bonus from Items increasing training, research, diagnosis or treatment only affects the rooms they are placed in. Therefore, training "Posters" and research "Servers" are just "cosmetic" when they are not placed respectively in a training room or a research room. Moreover, they only provide boost to the training/research room they are in and not to all training/research rooms of the hospital.22) Many VIPs (mayor, journalist, movie star, etc...) will visit the hospital and are great to get reputation, money, Kudosh or research points. However, 3 of the rival CEOs sometimes coming to the hospital are "evil" and their visits are unavoidable.

Jumbo McNally CEO of Jumbo Mega Corp:

- he sabotages machines reducing their durability by 50%, it's not just 50% of the current durability it's a flat -50 points loss of the maintenance gauge and can instantly destroy machines (!).

- he drops a ton of litter on the ground.

- he talks to patients and sometimes to staff making them instantly lose 10% happiness, he can talk to other VIPs as well like movie stars but not sure it has an impact on their review of the hospital since I still got favorable reviews from them when this happened.

- he can block a toilet (-100% maintenance gauge) when visiting the toilets room. Note that he only does that to normal toilets, if there are only golden toilets in the room he won't do anything.

Agatha Sphere CEO of The Orb Foundation:

- she brainwashes both patients and staff making them lose happiness over time very very quickly. In the case of patients, it means they are likely to rage quit before being cured. She can also brainwash other VIPs like the health minister but I am not sure it has any impact since I still got favorable reviews from them when this happened.

Augustus Lavender CEO of Holistix:

- he poisons plants making their maintenance gauge fall to 0 (withered plants have a negative attractiveness area of effect around them until they are watered).

- he randomly vomits on the ground.

Be very careful when Jumbo's CEO is in the hospital and make sure to quickly send a janitor to repair machines with low durability in rooms he is about to visit or has visited. Alternatively, you can also just pick-up the machine in the room he is in to prevent him from sabotaging it. Very often he is the main cause of machines on fire or destroyed ones when you don't pay attention. It can be frustrating and harmful to lose a fully upgraded machine because of him.23) In marketing rooms, an assistant only gains XP (between 4 and 5) when interacting with a Marketeer's Desk. So to speed up the leveling of these assistants, it's better to place a Marketeer's Desk per assistant. Items that trigger an animation like sofas or some of the boards for example should be avoided since they will make the employee lose time and not earn XP during that time.

General Tips - Part 3

24) Contrary to many theories, the hospital value is simply the addition of 3 elements (minus the loans):

- The current amount of cash

- The value of the physical assets in the hospital

- The profit factor (calculated based on the net revenue of the hospital)

So it's actually not "really" useful to spend money to make the hospital look better, or buy new buildings or things like that to increase the hospital value... The money you have is already taken into account in the hospital value. So the only thing to do to increase the hospital value is to make it more profitable or just wait for time to pass if it's already profitable to increase the amount of cash and thus the hospital value.25) In the job assignment screen, it's possible to tick/untick a whole line or column. To use this "hidden" functionality, you just have to right-click on the numbers on the left of the list or on the room icons at the top.

26) Chairs in working rooms (except the "Brain Chair") have no special benefit. Employees sitting on them will still lose their energy, happiness and needs gauges at the same speed. They used to have a special function by making staff stay in the room instead of leaving it when idle, but it's no longer the case. The option to have employees stay in the room is now managed in the policy menu. Note that chairs can still be useful to keep staff close to their workstation but except in big rooms, it doesn't always make a difference though because of the sitting and standing-up animations that can take time.27) Since it's possible to choose between having idle employees leave or stay in rooms in the policy menu, here are some of the advantages/disadvantages.

If employees leave the room when idle:

- Outside the room, they lose energy at a much slower rate.

If employees stay in the room when idle:

- It's much easier to keep staff in the room happy (room prestige + attractiveness happiness bonuses and no random trash/vomit on the ground).

- They will use sweet dispensers and coffee/chocolat makers to take care of their needs if there is any in the room. Idle staff outside the room won't use vending machines in hallways at all until they take a break.

- Having less people wandering in hallways is better to limit traffic issues.

- If patients come to the room, they won't have to wait for the employee to return.

As you can see the only benefit of employees leaving the room is the slower energy loss. While it's definitely great, I personally prefer the advantages of the staff staying in the room. Ultimately, it doesn't always make a big difference since with the first option it still takes around 2 weeks for an idle employee to leave the room. Except early game, idle employees should be relatively rare anyway unless the hospital is overstaffed.28) When building treatment rooms, it's better to put together the ones requiring a nurse on one side and the ones requiring a doctor on the other side, or in another building if there isn't enough space. When assigning treatment nurses/doctors to work in more than one room, it will be more efficient if the rooms are not too far from each other.29) A temporary solution to reduce queues at the GP offices or other diagnosis rooms is to lower the "Diagnosis Threshold for Treatment" (while still always having "Fast-Track Treatment Decision" active). At 50% most patients will go to treatment right after a single GP visit. However, it will greatly reduce the cure chance so do not forget to put back the threshold at a much higher level once the queue has been reduced.30) Pressing the white cross on the left of a portrait in the hire screen completely removes the applicant from the list. This makes a candidate slot available again allowing someone else to show up after enough time has passed. This is important to regularly remove bad candidates and make space for new ones. While it seems quite obvious, it's included in the tips because many players have reported not knowing about this.31) Another great feature that many players tend to discover late (even though it's not really that hidden :p) is the room copy. When clicking on a room, there is a "Copy" button at the bottom of the room info panel. Clicking on it creates a copy of the room with all the items it contains that you can then place where you want. Note that the copy of a room having a level 2 or level 3 machine will instead have a level 1 machine.

32) can struggle a lot with all their tasks especially during missions with a lot of natural disasters. Here are some things that can be done to reduce their workload :

- Remove all plants from the hospital, use other items that don't require maintenance.

- Make sure to use the Big Bins, these are by far the best ones to reduce the workload of janitors. In cold environment using the incinerator from the Close Encounters DLC inside rooms can also help a little bit but I don't recommend it in hallways.

- If you have spare money, use the Water Closets or the Golden Toilets instead of the normal ones. They are more durable and will therefore also reduce the workload.

- Avoid buying unnecessary or far away plots, otherwise janitors will waste a lot of time just moving from a building to another.

- If you have the Pebberley Island DLC and if the mission is in a hot environment, do not use Aircon Units at all. Instead rely completely on Ice Sculptures to lower the temperature since they don't require maintenance.

- If you want to reduce the workload even more, you can use Drinking Fountains or Water Coolers and Sweet Dispensers (or even Carrots from Off The Grid if you want) since they don't require maintenance compared to other food/drink machines. It might be a bit overkill though, using items providing bonuses like the Luxury Snack Machines is usually better.33) Here is a table showing all buffs and debuffs given to staff members when the energy and happiness are above or below a threshold.

(happiness below 20%)

(happiness above 80%)

(energy below 5%)

(energy between 5% and 20%)

(energy above 80%)-20% move speed+10% move speed-40% move speed -50% happiness-20% move speed

-20% happiness+10% move speed

+10% happiness-10% diagnosis and treatment skill

-2% happiness for patients when taking care of them+10% diagnosis and treatment skill

+5% happiness for patients when taking care of them-20% diagnosis and treatment skill

-5% happiness for patients when taking care them+10% diagnosis and treatment skill

Doctors also get +10% research skill-20% customer service and marketing skill

-2% happiness for patients when taking care of them+20% customer service and marketing skill

+5% happiness for patients when taking care of them-20% customer service and marketing skill

-4% happiness for patients when taking care of them+20% customer service and marketing skill-20% maintenance and upgrade skill+20% maintenance and upgrade skill-20% maintenance and upgrade skill+20% maintenance and upgrade skill

Basic Tips To Prevent Bankruptcy

Here are some tips to help you get a profitable hospital.

An important thing to note is that monthly expenses mostly come from wages (and loans) so it's actually not that hard to run a profitable hospital in most missions if you are careful. There is also an energy bill but there is not much you can do to reduce most of it and the amount is usually low anyway (see the "Energy cost" chapter for more info).

1) Only build rooms when necessary. There is no need to build all diagnosis rooms directly at the start of the mission. Just build one room and only build a new one when necessary (when the in-game notification telling you that a patient couldn't be diagnosed shows up). Of course, the same applies to treatment rooms, only build them if it's required to cure patients. However, if you have enough money do not hesitate to build treatment rooms when they are required since they give more money than diagnosis. 2) Do not recruit extra employees at the beginning, only recruit what's necessary to run the hospital. If there is no queue, a doctor or nurse can even take care of more than 1 treatment room. For example, I easily managed to get 3 star during the Croquembouche mission with 2 doctors taking care of 6 of the different treatment rooms and 2 nurses taking care of 5 of the other treatment rooms. It was possible because I kept the hospital at level 11 (to have less patients at once) but you get the idea, it's not necessary to have en employee per room in the case of treatments. 3) Never recruit employees with the "Expensive" trait (called "Wants more money" in the recruitment screen). Of course, avoid any other negative trait when possible but "Expensive" is one of the worst. On the contrary, one of the best trait to look for is definitely "Cheap" (called "Will work for peanuts" in the recruitment screen). 4) Never recruit overqualified applicants i.e. those with more than 2 stars since they cost way too much every month, except for example if you see a level 3 doctor with 3 General Practice skills and no negative trait. Recruited overqualified employees cost more monthly than employees who reached the same level after being recruited as juniors. 5) Never take a loan or do it only when you are confident it will help or if it's really necessary, for example to save your hospital by building a treatment room that will make it profitable. I used to always take loans when I started playing this game to quickly invest the extra money. However, it's often a bad idea since it makes the game more difficult with the extra monthly expense it brings if you are not careful. Note that the interest cost by itself is not that high, it's just that if you are in a bad situation after taking loans, it won't help to "lose" money each month. 6) Do not needlessly give pay rise to your employees just because you feel generous, even during promotions. Only increase salary when they are unhappy until they are satisfied (yellow neutral emote) but even that is optional if you are already struggling with money. Employees are fine as long as their happiness gauge doesn't go below 20%. Even if it does, making them take a break is usually enough to bring back their happiness to a higher level. 7) Emergencies are great opportunities to earn a lot of money. If possible, make sure to always accept them. It doesn't matter if your cure rate is not good enough to successfully complete the emergency mission. You will get most of the money from the emergency patients paying their treatment, not from the mission reward itself. Moreover, do not hesitate to increase price of the emergency illness to +100% as long as those VIP patients are in the hospital. Since emergency patients don't spend a lot of time in the hospital, they are usually happy which means they will very very rarely refuse to pay. It's a perfect opportunity to get even more money from emergencies. 8) Increase all treatment prices to +30% or more (do not touch GP office and diagnosis prices to avoid the happiness loss there). Don't forget to check the prices screen regularly since all new illnesses start at 0. Note that some patients won't pay when prices are too high but it should not often happen if your patients aren't too unhappy and will largely be compensated by those who pay. The only other penalty is that you will lose hospital reputation but except if it's a mission objective, it's not a big deal.

Reputation mostly influences the flow of patients coming to your hospital. Having less patients is sometimes more beneficial than having endless queues anyway. It also affects the time before new candidates show up on the hire screen. Even during missions where reputation is an objective, you can still easily earn reputation with a good cure rate despite high prices, or just launch marketing campaigns to quickly earn some. 9) While it's beneficial to promote and train employees taking care of diagnosis, most treatment employees are already fully efficient at level 3 or 4 if you have upgraded machines. In that situation, promoting them all the way to level 5 is a waste because they will cost much more money for nothing. See the "Staff specialization" chapter for more info.

Advanced Tips To Prevent Bankruptcy

10) If you really struggle with the starting cash, don't buy unnecessary items in rooms until you get more cash. Don't bother with gift shops, newsagents, the café room or even benches they are all unnecessary/optional and can even have negative effect on queues. You can also save money by not building toilets, a hospital (without massive queues) can run just fine without them. Just build toilets later when you can afford them. 11) If one of the first doctors to recruit has the qualification "Radiology" or "Genetics", you should consider building respectively a Mega-Scan or a DNA Lab (if you already have them unlocked) as the first diagnosis room after the GP's office. These are the most expensive diagnosis rooms but also the most profitable by far. If you do that, you just need to be careful with other expenses early during the first few months.

Diagnosing 11 patients is enough to cover the initial cost of the Mega-Scan or DNA Lab room. Diagnosing just 1 patient is enough to pay the monthly salary of the doctor working there (even a level 5 doctor). Most treatments still give more money but these expensive diagnosis rooms can help a lot early, especially when there is no other diagnosis room or if it's always busy. 12) Research can be a good way to earn money but note that it's an investment (room to buy, doctor to pay, training to do) and will take some time to truly become profitable. See the chapter "Money research project analysis" of this guide for more info.

To quickly get the most out of the research system, level 3 doctors are enough. With 5 of these level 3 researchers you can complete the 20 000$ project in less than a month on average. The good thing about research is that no matter how the rest of the hospital performs, you will always get a regular income. Just make sure to instantly restart the research once it ends, otherwise it would be a waste of money to pay researchers for nothing. 13) With the feature allowing to change the diagnosis threshold for the patient to automatically be sent to treatment also comes a special way to quickly earn money which is almost an exploit. The idea is to set the diagnosis threshold at 50% and also make sure "Fast-Track Treatment Decision" is activated (in the "Policy" tab of the "Overview" menu).

In this situation most of patients will only see the GP office or rarely more than 1 diagnosis room before going to their treatment room. Since patients are quickly "cured" after their arrival in the hospital, money will be earned faster too. To take advantage of that, you could also raise all prices to +100% (except for GP's office and diagnosis rooms). If your hospital is big enough with no queues at your treatment rooms, revenue can increase massively.

Of course, with such a low diagnosis threshold, cure rate will probably be low so expect more ghosts and reputation loss. Keep in mind also that if the cure fails, patients will need more happiness (above 55-65% depending on the illness) to be willing to pay +100% prices. 14) This is more a special strategy than a tip but I think it's worth mentioning marketing since it can be effective. The idea is to start an illness marketing campaign to make most patients afflicted by the aimed disease come to the hospital. To take advantage of that, it's necessary to build many treatment rooms to cure that illness.

The most obvious benefit is that you can attract an easy to diagnose/cure illness which means you will process patients faster and quickly earn money. Most people tend to do marketing for the Pharmacy. It's not bad because the room is cheap, nurses working there are also cheaper than doctors. The issue with Pharmacy is that it's not just taking care of a single illness but many of them including some that are quite hard to diagnose and cure. Safer options are Animal Magnetism and Lightheadedness but it's more expensive to build many of those rooms.

However, note that this strategy has some downsides. Obviously, there is the initial cost to setup everything. Building the necessary rooms and recruiting people to take care of the patients can easily increase the hospital level too and bring even more patients than expected... 15) Here is a more extreme strategy if you want to save a ton of money but can be tricky to manage. The idea is to always keep the salary to the minimum of employees working in rooms like nurses and doctors (not recommended for janitors). Put the salary gauge completely to the left during promotions. It means that at level 5 the employee can have the salary of a level 1 junior. The issue is that the underpaid staff will get the "Pay Rage" debuff which gives a massive -50% happiness !

However, it's possible to somewhat compensate this by making sure the rooms where the employee is working has a prestige level of 5 (for the +30% happiness boost), it's also important for the toilets and break room to be level 5. Then make sure the attractiveness is fully green to always give the maxed "Attractive Environment" buff (+25% happiness). It's also recommended to have the attractiveness green in the whole hospital and not just in the rooms to limit happiness loss when the employee takes a break.

As long as the employees take care of their needs, they should remain above 20% happiness (usually it will fluctuate around 40-50%). Giving the skill "Emotional Intelligence" (+10% happiness) to treatment staff can help. The "Positive" trait (+10% happiness) is obviously great too but I recommend this in priority for diagnosis staff since giving them an utility skill like Emotional Intelligence is not optimal.

Paying a level 5 doctor around 17 000$ instead of more than 40 000$ is insane.

The "Go Slow" Strategy - Part 1

There are many ways to play this game but an issue many players have is to "expand" too fast and are caught in a vicious circle. In this situation, they can become overwhelmed and start losing money.

The amount of patients coming to the hospital mainly depends on the hospital level. The vicious circle is that once you have queues, you build more and recruit more employees which increase the hospital level which makes more patients come to the hospital, increasing queues, etc...

The goal of the slow strategy is to be patient and stop this cycle by keeping the hospital level low. What helps attain this objective is training of the diagnosis staff, machine upgrades and the use of the policy tab. I will also include other "tips" that are not directly part of the strategy but will help make the hospital profitable.

Note that this should make getting 3 stars in all hospitals relatively "easy" since you will have a better control on the patients flow, recruitment, training and expenses. Obviously, this strategy isn't really useful for the wave missions since the hospital level doesn't affect the size of waves.

General guidelines :

- When recruiting make sure to get the employees that are as low level as possible and without any bad trait. Unless you have no choice, only train employees you intend to keep.

- If you see junior applicants without bad traits, recruit them and train them. If you were forced to recruit a bad employee (very bad trait or skill set), make sure to replace them as soon as possible with a good one.

- When possible, use your own employees to train others. To train employees with a skill that isn't present in the hospital yet, you can temporarily recruit someone with the desired skill to act as a trainer and then kick him/her once it's done. It will be cheaper than paying a guest trainer.

-When building rooms, make sure to always increase them to prestige level 5. Gold Star Award is a great item to level up the room. In diagnosis rooms, make sure to place as many Medicine Cabinets (or other similar items) as possible if you can afford them.

- To help janitors, try to have a Big Bin in all rooms and enough in hallways. Do not use plants.

- Only use Luxury Drink and Luxury Snacks Machines. Do not hesitate to also place something to drink and the Sweet Dispensers in rooms.

- Only buy plots once you need the extra space (or to complete a mission objective related to that).

- Make sure the whole hospital is green when using the attractiveness overlay (or at least the areas where patients/employees are). Use items like the Brain Jar, Posters/Paintings, etc... If you have the cash and want to increase attractiveness in a large open area, the Horatio Statue or the Dragon Ornament are powerful.

- Always keep the diagnosis rooms as close to the GP offices as possible and ideally in the same building.

Early game :

- First of all, make sure to activate the option "Fast-Track Treatment Decision" in the policy menu (you also can wait until queues start forming up before activating it, just make sure not to forget).

- At the start of the game recruit a GP doctor and build a GP office. The GP doctors should have training priority over everyone else. As soon as they level up, train them (only give them the General Practice skills).

- Consider recruiting another good doctor if you see one among the candidates to work in your first diagnosis room. Make sure to reject the bad applicants to make place for better ones.

- If you see one or two good nurses, get them too. There is a high chance that the pharmacy and ward will be required early.

- Unless you intend to do marketing, you shouldn't recruit more than 1 assistant. A second one can be recruited to fluidify the flow of patients but much later. An assistant with high Custom Service will process patients at the speed of light (only give them the Custom Service skills). Even if you intend to use marketing, you should wait for the hospital to be profitable first before recruiting and building the room.

- Recruit a janitor with the Mechanics skills or a good junior to train him. A bit later recruit another janitor, if possible with the Ghost Capture skill to at least be capable of removing them. The janitor specialized in upgrading machines should have priority in training compared to other janitors (only give this specialist the Mechanics skills).

- Build a Training room, if you have space build a big one. Cover all walls with Anatomy Posters to increase the training speed. When you have spare cash do not hesitate to add Encyclopedia Bookcases II or Anatomy Models in the room. If you need cash at any time, you can just sell some of these items to get your money back.

- Build a small Staff Room and later build a new one in any new building you unlock. Note that this is entirely optional, with this strategy the benefit of having staff rooms is very limited. Not building them can help keep the hospital level low.

- Build small Toilets if you want and later build new ones in any new building you unlock. As silly as it sounds, this is also optional. If you are in a hospital with small buildings, you can consider not building any Toilets room at all to save space. The attractiveness, the room prestige at level 5 and luxury drinks/snacks will easily compensate the happiness loss. However, make sure to place Hand Sanitisers in the hospital if you don't build Toilets.

- From now on only build what you are asked to build...

- Once a patient has been fully diagnosed, build the required treatment room.

- Every time a new illness is discovered, open the Prices menu and increase its treatment price to +100%. And when you have a first patient who refuses to pay, lower the price of "Diagnosis: GP's Office" to -80%. While some patients will still refuse to pay, there should be more who pay which will compensate and heavily increase income.

- When it's necessary to build a diagnosis room because a patient couldn't be fully diagnosed, you can build any of the diagnosis rooms (but only build one at first). X-Ray and Fluid Analysis rooms are great early and mid-game. Mega Scan is also quite good and become more interesting late game. With that said, if you see/train a doctor with the Radiology skill at the start of the mission, Mega Scan is amazing to earn money even though it's expensive to build.

- When you see queues forming up because an employee is taking a break, don't recruit or build anything ! Wait and see if the queue gets processed fast enough once the employee is back.

- Keep promoting and training your diagnosis staff in priority. Then the mechanics janitor and if queues are starting to form up at the reception, train the assistant. If necessary you can recruit replacements during a training and kick them after. Train the rest of the employees only when you have a good amount of cash.

- Prioritize upgrading the diagnosis rooms. Upgrade treatment machines only when you have a good amount of cash (at least around 80k $).

- Always check the new applicants showing up to not miss any good candidate. You can usually recruit 1 or 2 extra nurses or doctors early to train them for the next rooms you will build.

- For the treatment staff (except Wards, Psy, DNA Lab), don't teach them Pharmacy Management or Injection Administration. Give them Treatment I + Treatment II + Stamina Training and that's all, never promote them to level 4.

- Make sure to properly assign doctors/nurses to the good rooms. Only doctors with the GP skills should work in the GP offices, only the ones with the Diagnostics skill in diagnosis rooms, etc... Make sure the treatment staff can work in all possible treatment rooms (except Wards, Psy, DNA Lab and Surgery for doctors since their skillset is different).

- Do not recruit one treatment employee per treatment room. Only recruit an extra treatment employee if the queues aren't going down during several weeks in a row.

The "Go Slow" Strategy - Part 2

Maintain the cap :

- A temporary solution to reduce queues while waiting for an employee to level up or get trained is to lower the "Diagnosis Threshold for Treatment" in the policy tab to 50%. Don't forget to put it back to a higher level later to increase the cure rate.

- When you see that the GP office has an unending queue during several weeks, it's time to build a new one and recruit/train a new GP doctor if it's not already done. The same can be done with other diagnosis rooms.

- Keep in mind that since you have fresh employees, they won't be as effective as the one you already have. So until they gain some levels, queues can take time to go down but be patient.

- When preparing a new diagnosis room, if possible close the room and make the janitor upgrade the machine to its max level before opening it.

- In most hospitals you shouldn't need more than 4 GP offices and 6-8 diagnosis rooms. Do not build more than that and just keep training your staff and upgrading the diagnosis machines.

- With 3 or 4 GP offices, you can consider recruiting an extra GP doctor who will help keep the queues under control when others take a break and train. At this point, you can also consider having an extra doctor/nurse for other diagnosis rooms if you have duplicates but again only if it's really necessary. It's still a better solution if queues can be reduced just by having an extra employee instead of building a new room.

- Even though there are some exceptions for example in early missions when there aren't many different illnesses, it's rare to need more than 1 of the same treatment room. Again only build one more if it's absolutely necessary. The most problematic treatment room is usually the Surgery room because of how slow it is but having only one is still fine even if you have some queues there.

- Regarding janitors it's more complicated to know when and how many are needed. During missions with natural disasters you will often need much more of them. You can use a rule like recruit 1 janitor every 3 or 4 machines you place. Personally, I just pay attention to what's going on and recruit more when I see that the ones I have are overwhelmed or if things take too much time to get cleaned/repaired.

- When the hospital is doing good enough, having an extra training room can be very useful to keep everyone trained.

- If you always build different diagnosis rooms you may see that at some point a diagnosis room will be much more used than the other ones. That's why instead of having 4 different diagnosis rooms, it's usually better to have 2 pairs of 2 diagnosis rooms to limit queues (for example 2 X-ray and 2 Fluid Analysis rooms). Ward is the exception since having just 1 is often fine.

- Later, if you have for example a marketing room or a second training room that you don't need anymore just delete it and fire the marketing assistant if it can help lower the hospital level.

With this strategy the hospital level should (almost) always be below level 16.

Here is an example :

1. This is Croquembouche mission which is supposed to be one of the "busiest" hospital of the base game.

With my strategy, this hospital only needs 2 buildings to efficiently work and just 3 GP offices. At this point, the hospital is fully "self-sufficient" with no queue issue. It's clean, takes care of patients very fast and is very profitable. In comparison, look at some youtube playthroughs or walkthroughs for example and you will see huge and often chaotic hospitals.

2. The central building is dedicated to diagnosis and since there is space, there are also some treatment rooms there:

In this setup, diagnosis is managed by the 3 GP Offices, 2 Mega Scan rooms, 2 Psychiatry rooms and 1 Ward. Except the Fracture Ward, all other treatment rooms in this building are the ones requiring doctors.

3. The other building contains the rest of the treatment rooms:

The DNA Lab there is only curing patients and not diagnosing them. Note that I have 2 Surgery Rooms, this is the only treatment room with this strategy that often has some queue issues because of how slow this room is. Having just 1 is fine though and I usually stick to 1 in most hospitals. However, I decided to add another one since it didn't make my hospital gain a level and it solves the queue issue.

At some point during the mission I had a second training room and a marketing room but I deleted them since they were no longer needed.

4. I had 31 employees during this mission:

Not much to say here, just make sure to specialize them and affect them only to the rooms where they should work. See the chapter called "Staff specialization" of this guide for more info on how to train them.

5. Once you understand this strategy and know how to use it, the game becomes quite easy:

Diagnosis Speed

Here is an average diagnosis time for each room from the moment a patient enters to when the patient leaves the room. Those data were gathered while using simple room design at minimal size.

General Diagnosis: 26 seconds

Cardiology: 31 seconds

Ward: 70 to 90 seconds (quite inconsistent because of the nature of the room and some patients don't change clothes)

Psychiatry: 35 seconds

Fluid Analysis: 34 seconds

X-Ray: 22 seconds

M.E.G.A Scan: 33 seconds

DNA Lab: 28 seconds

Don't bother with the skill Motivation, it doesn't seem to change anything regarding the working speed so only get it for janitors if you want since move speed is good for them.

I also looked at the machine maintenance gauge and in all rooms it depletes by 10% for each patient except for the Cardiology that only depletes by 8%. In the case of General Diagnosis, the machine isn't always used during diagnosis making the machine not lose maintenance at all sometimes. So theoretically these 2 rooms have less downtime for maintenance.

While diagnosis speed and maintenance can be important, keep in mind that depending on the illness some rooms are better or worse at diagnosing it than others. These illnesses/rooms modifiers can have a better effect on queues than the diagnosis speed/maintenance downtime. More info can be found in the "Illnesses and diagnosis modifiers" chapter.

Differences Between Bins

Many of us have been wondering what are exactly the differences between the bins.

Prices and how to unlock the bins:

Bin = 50$

Big Bin = 100$ (unlocked with 20 Kudosh)

Toxic-waste Bin = 200$ (unlocked with 50 Kudosh after getting 1 star at Smogley)

Recycling Bin = 50$ (unlocked with Off The Grid DLC)

Elephant Bin = 120$ (unlocked with Retro Items Pack DLC)

Shark Bin = 400$ (unlocked with Culture Shock DLC)

Bins have a "maintenance" gauge and when the gauge is at 0, it means the bin is full. Therefore, when an NPC throws something in a bin, it loses a bit of the maintenance gauge:

Bin = -6%

Big Bin = -3%

Toxic-waste Bin = -10% (!)

Recycling Bin = -15% (!!)

Elephant Bin = -6%

Shark Bin = -5%There is no difference when an NPC vomits in a bin, they all lose 10% of the maintenance gauge. So as you can see, the Toxic-waste Bin isn't that great and the Recycling Bin is the worst since it fills much faster than the other bins...

However, there are additional factors to take into account. All bins (except the Toxic-waste Bin and Shark Bin) cast a negative attractiveness area around them when they fill up. The lower the maintenance gauge is, the stronger is the negative attractiveness area. The advantage of the Toxic-waste Bin and Shark Bin is that even when full, they don't have any negative attractiveness area around it.

Here is how the attractiveness looks like when bins are full (green is good, brown is bad):

Note that items that increase attractiveness somewhat compensate. So if you use any bin other than the Toxic-waste or Shark ones make sure to have them near a plant, posters or anything else that increases attractiveness.

It's not as noticeable since by default the hygiene of a hospital is completely green but all bins (except the Toxic-waste and Shark Bins) also reduce hygiene around them. Like attractiveness the effect is gradually amplified depending on the bin maintenance gauge.

Hygiene stays slightly green so by itself it may not be that bad, however if there is anything else that is dirty on the ground (vomit, trash, etc..) it won't be green for long since the dirtiness will "stack".

Even though the Toxic-waste and Shark Bins have advantages, I think the Big Bin remains the best one. It will take much more time for it to be full which will significantly reduce the workload of janitors.

What about the incinerator from the Close Encounters DLC ?

This is a special bin/radiator combo I don't recommend using, at least not in hallways.

- Contrary to other bins, people can't vomit inside. This means they will often vomit on the ground instead which is bad...

- For some reason, people don't always throw trash in the incinerator and throw them on the ground instead but I suspect some kind of bug as it doesn't always happen.

- Like other radiators, this item increases the energy bill. It costs 30$ each month which is fine as a radiator but obviously expensive as a bin.

- By default it increases temperature around it with a radius between a small and a normal radiator. However, the temperature increases/decreases depending on the maintenance gauge state. When the maintenance is very low, the temperature in a large area around it increases a lot making it fully red (too hot). This makes this item unreliable as a radiator.

- Note that janitors can't interact with the incinerator at all despite the presence of the button to call a janitor. Indeed, the maintenance gauge automatically increases over time meaning it's "self-sufficient". It loses 10% maintenance every time someone throws trash inside. Even though this bin doesn't need a janitor and could be used to reduce their workload, the fact that vomit still requires a janitor nullifies this advantage.

It's probably acceptable to use this item inside rooms instead of a radiator if you want something between a small and normal radiator. However, it's both unreliable as a radiator and as a bin to have outside in hallways.

What about the Wormhole Bin from A Stitch in TIme DLC ?

- Similar to the incinerator, it's a self-sufficient bin. Its maintenance gauge automatically increases over time, so it can help reduce janitors workload.

- When someone throws trash inside, it loses 10% maintenance but contrary to the incinerator people can also vomit inside which makes this bin much more useful.

- It never negatively affects attractiveness and hygiene when it's full.

- When it's empty, it decreases temperature around (slightly less powerful than the Small Air Con Unit). When it's full, it increases temperature around (slightly less powerful than the Small Radiator). The fact that the temperature changes can make some areas too hot/cold which is annoying.

- Another downside is that it's very expensive (700$) and also costs 35$ each month.

The Wormhole Bin is great but not sure it's worth the price. The temperature issue isn't such a big deal but I prefer not to deal with it and just place my bins wherever I want without worrying about that.

Differences Between Toilets

Many of us have also been wondering what are exactly the differences between the toilets.

Prices of the toilets:

Normal Toilet = 500$

Golden Toilet = 2 000$ (unlocked with 40 Kudosh after getting it as a "free" DLC)

Water Closet = 2 000$ (unlocked with 40 Kudosh after getting the Retro Items Pack DLC)

Here is how you can get the Golden Toilet free DLC:

https://support.sega.co.uk/hc/en-gb/articles/360000337357-How-To-Redeem-the-Golden-Toilet-DLC

Toilets have a "maintenance" gauge, when the gauge is at 0, it means the toilet is blocked and won't be used anymore. Therefore, when an NPC uses the toilet, it loses a bit of the maintenance gauge:

Normal Toilet = -10%

Golden Toilet = -5% only

Water Closet = -5% only

Surprisingly and contrary to popular belief, golden toilets (and water closets) have a great advantage over the normal ones. Being much more durable means that janitors won't have to unblock them as often which gives them time to focus on other tasks which can also "indirectly" reduce queues in toilets. Note that there is no difference when an NPC vomits in a toilet, they all lose 10% of the maintenance gauge but this shouldn't happen that often since NPCs are more likely to vomit in a bin.

Contrary to a normal toilet, placing a golden toilet or water closet also casts an attractiveness area around it. The area seems to be as big as the one from a plant which is very useful to keep the environment attractive. As a reminder, an attractive area gives NPCs a buff called "Attractive Environment" that increases happiness (or at least reduces the natural happiness decay over time).

Here is how it looks like with obviously the golden toilet on the left:

Note that toilets slowly lose attractiveness when the maintenance gauge goes down. This is problematic in the case of normal toilets because they start casting a negative attractiveness area around them. When they are at around 20% maintenance or below, if there is nothing giving an attractiveness boost nearby, the negative effect is so strong it will give NPCs the "Ugly Environment" debuff (reduces happiness over time).

In the case of the golden toilet and water closet, by themselves they just stop giving the "Attractive Environment" at around 35% maintenance. Even at 0% maintenance they don't negatively affect the attractiveness.

Here is how the attractiveness looks like when both normal and golden toilets are blocked (0% maintenance):

Another advantage of the golden toilets and water closets is that they increase room prestige a lot making it easier to increase the room prestige level. Room prestige level doesn't seem to affect patients at all in the toilets. However even in there, it's still useful for employees because they still get a happiness boost from it while they are in the room.

Finally, the last advantage I discovered is related to Jumbo McNally the CEO of Jumbo Mega Corp. When this VIP visits the toilets room, he uses and blocks a toilet which instantly puts its maintenance gauge to 0% requiring a janitor to fix it. However, he sabotages only a normal toilet, if there are only golden ones or water closets in the room he won't do anything and just leave the room.

If you can afford it (2 000$ is very expensive), I highly recommend using the golden toilets or water closets. The advantages they provide compared to normal toilets are really good. If you use normal toilets, make sure to have objects nearby providing an attractiveness boost (like awards, posters or paintings that can be placed on the wall behind the toilets).

How Does Treatment Work ?

Contrary to the diagnosis phase, a patient goes to only one treatment room and then leaves the hospital. Except to complete a mission objective, cure chance itself isn't that important because even if a treatment fails, the patient will still pay the same amount of money.

Even though it was not easy to find exactly how treatment works, surprisingly it completely changes how to optimize staff training making most older guides outdated on this matter.

As we can see in the patient info screen, estimated chance of cure relies on 4 main factors (+ hidden ones detailed below). Note that If you are interested, you can find the formula below that calculates the cure chance.

1. Illness Difficulty:

Many people don't know but this has 2 functions regarding the cure chance. Obviously, the higher the value, the more difficult it will be to get a good cure chance. However, note that it also defines the lowest cure chance value you could get for an illness.

If an illness difficulty is 60%, the cure chance will "never" be lower than 40%. If the illness difficulty is 30%, the minimal cure chance will "never" be lower than 70%. I use quotes for the word never because there is an exception to that, see Diagnosis Certainty below for more info.

2. Diagnosis Certainty:

Any patient with a diagnosis value above 50% can be sent to treatment, manually by clicking on the green cross under the patient info screen, or automatically depending on the diagnosis threshold defined in the policy menu. Actually, the diagnosed illness of the patient will always be the good one and the patient will always be sent to the correct room (it would have been "fun" to see a clown lose his head in the De-Lux Clinic).

What diagnosis certainty does is lower the hard cap of the cure chance. If diagnosis certainty is at 60%, the cure chance can never go higher than 60% even if you have the best possible nurse/doctor with fully upgraded machine.

The hard cap also lowers the minimal cure chance value we talked about while explaining illness difficulty. This means that if the illness difficulty is 30% and the diagnosis certainty is at 55%, the minimal cure chance won't be 70% anymore since the cure chance can't exceed 55%. Note that the minimal cure chance won't be 55% either, it somewhat scales depending on the diagnosis certainty so it will now be 38.5%.

3. Upgrades and Staff Skill:

I talk about both upgrades and staff skill here because in the formula they are added together to form a single variable.

The Upgrades factor takes into account 2 elements:

- The machine level if a machine is used to cure the illness. A level 3 machine gives +50% Treatment Power. A level 2 machine gives +25% Treatment Power. A level 1 machine gives 0 Treatment Power.

- Treatment boosting items like medicine cabinets or Treatment bookcases (in psy rooms) for example which increase Treatment Power just like the machine.

Note that having +50% Treatment Power makes the "Upgrades" value in the patient's Info tab display 100% instead but the real value used in the formula is still 50 (I guess they just wanted to base this gauge on machine level, 100% means fully upgraded machine).

Staff Skill is simply the Treatment Skill value shown in the "Stats" tab of a medical staff working in a treatment room. Basically, Treatment Skill from staff is the same thing as Treatment Power from machine/items.

Very Important info for staff training !

Contrary to diagnosis, the way the game calculates the cure chance makes it useless to have a combination of Treatment Skill + Treatment Power superior to 100% !

Having more than 50% Treatment Skill for an employee working in a room with a level 3 machine (+50% Treatment Power) won't improve the cure chance. Therefore, level 3 employees with 2 Treatment qualifications are enough to have the best possible cure chance when they use level 3 machines.

The same can be said for other employees like surgeons who only need 4 Surgery qualifications to get 100% Treatment Skill (or just 3 Surgery qualifications if they are both level 5 and "Happy" since gaining a level and being "Happy" give +10% Treatment Skill each).

4. Cure Cap:

Even though Diagnosis Certainty lowers the hard cap of the cure chance, there is already a hard cap defined for each illness. Almost all diseases have a cure chance hard cap of 99% which means there will always be 1% chance to fail the cure. Note that Mime Crisis and Beach Wail illnesses have a hard cap of 90% instead.

5. Cure Chance Formula

CureChance = DiagnosisCertainty * (((100-IllnessDifficulty)) * (1-(StaffSkill/100+Upgrades/100) + CureCap * (StaffSkill/100+Upgrades/100)) /100)

Note that this is a "simplified" version since by itself it's not enough take into account the conditional aspect of the cure cap. However, here is a treatment calculator that includes it:

https://docs.google.com/spreadsheets/d/1BgDsri_PbmnuwNZP7V5ljWrYKRS5ZAf_asSjnxAbSmc/edit?usp=sharing

In case you want to use/modify it, just make a copy of the spreadsheet ("File" > "Make a copy"). Change the values of the Illness Difficulty, Diagnosis Certainty, Staff Skill, Upgrades and Max Cure Chance to what you want.

Update: The UI was updated in a recent patch to show an "Estimated Chance of Cure" on the patient info screen with 2 numbers for rooms having an upgraded machine instead of just one number. The number on the right is the actual cure chance of the room. The number on the left shows the cure rate without taking into account the upgrade level of the machine (but still takes into account items boosting treatment power).

Don't worry too much about that, it doesn't change how the real cure rate is calculated. The final cure chance is even displayed on the patient info screen when treatment works or fails. I think this UI change was done because of the implementation of the Herb Garden room which can have both upgraded and unupgraded "machines" inside the room at the same time.

After publishing how the cure chance works, I saw some people stating that because the cure cap is at 99% you only need 99% diagnosis certainty to get the max possible cure chance but this is wrong. You still need 100% diagnosis certainty to get the best cure chance otherwise you will get around 98% cure chance instead.

Staff Specialization - Part 1

Based on how diagnosis, treatment and other things work in the game, here is what I personally consider optimal training. Most of the missions are not that hard so you can still win by mixing the skills you want, however specialization is much more efficient.

In the tables below, some rooms are grouped together since they use the same skill set. For those rooms I recommend managing job assignment to make employees work in all of those rooms and no other ones, as long as rooms aren't too far from one another. That way it's for example possible to only have 2 or 3 doctors/nurses taking care of many treatment rooms which adds a bit of flexibility, instead of having 1 employee per room. It also significantly reduces costs.

For both Doctors and Nurses managing diagnosis, I don't think any skill is better than those increasing diagnosis skill, diagnosis is just too important and greatly improves the efficiency of a hospital. For treatment contrary to diagnosis, having Treatment Skill + Treatment Power superior to 100% is useless (check "How does treatment work ?" chapter for more info). For employees taking care of treatment, when they reach +100% treatment skill/power in combination with machine or boosting items, "Stamina Training" is the only utility skill that is worth learning in my opinion.

For treatment rooms with a machine, there are technically 2 strategies to get the max cure chance :

- Upgrade the machine to level 3 and have a level 3 employee with 2 treatment skills (I recommend "Stamina Training" for the third skill but you can teach something else if you want)

- Or do not upgrade the machine at all and have a level 5 employee with 5 treatment skills

The first strategy is the best in the long run because by keeping the treatment employees at level 3 forever, you will save a lot of money each month since their salary is lower than at level 5. You will also reach the max cure chance much faster because getting an employee to level 5 takes a lot of time.

"Bedside Manner" for treatment can be useful to make patients' happiness go above the threshold that will make them pay higher prices. The threshold depends on the room/illness/price, but as long as patients are cured this threshold tends to be somewhere under 50% happiness. So if most patients are often above 50% happiness when paying, "Bedside Manner" matters less. It makes it hard to quantify how good this skill really is compared to cost savings from lower salaries of unpromoted staff. Note that "Bedside Manner" doesn't work on surgery nurses.

"Pharmacy Management" and "Injection Administration" skills are useful early but useless in other rooms than Pharmacy/Injection and later on, so I don't use them often. Having a great cure rate is usually not that important early anyway. However, if your Pharmacy and Injection Rooms are always full of patients, you can definitely consider those skills for nurses that are only assigned there.

Regarding "Stamina Training" is it worth promoting an employee and pay the extra money each month just to get this utility skill ?

- By default an employee works around 134 days before taking a 20-days break.

- With the "Stamina Training", the employee will work around 178 days before taking the same 20-days break.

The stamina employee will work 44 more days before taking a break but it doesn't mean that the employee will work 44 more days per year. In average the stamina employee will "only" work around 13 more days per year. If you want to save money, it's probably not worth it to promote an employee just to get this utility skill. It's more efficient to just build an extra room and recruit a new employee once there is a long queue. Note however that "Stamina Training" is still worth a promotion in surgery in my opinion since getting dressed and taking care of patients takes a very long time there.

In the setups below, when there are for example only 3 skills I recommend not promoting those employees further than level 3 since they don't really gain any benefit from that. Promoting them will just cost your more money for nothing since salary increases with level.

Doctors:

Rooms Qualifications

If taking care of diagnosis (and treatment):

If taking care of treatment only:

If taking care of diagnosis (and treatment):

If taking care of treatment only:

Above setup at level 4 already has max

cure chance but I think it's worth getting

Stamina Training for this room:

If they work with fully upgraded machines:

If machines aren't upgraded:

Efficient enough and requires

less micro-management:

Faster research and better long

term profitability for money research:

Nurses:

Rooms Qualifications If taking care of diagnosis (and treatment):

If taking care of treatment only:

Pharmacy

Clown Clinic

Chromatherapy

Injection Room

Pest Control

Cryptology

Doghouse

Urban Mythology

Indentification

Escape Room

Self-Assembly

Toad Hall

Woodwork

Farmacology If they work with fully upgraded machines:

If machines aren't upgraded:

Treatment skills of nurse in surgery are

useless so instead you can assign a single

nurse there with "Stamina Training" if you want:

If they work exclusively with

upgraded Flower Beds:

If they work with Vine Yards (or

unupgraded Flower Beds):

Staff Specialization - Part 2

"Customer Service" skill makes assistants process patients much faster. Moreover, when they process patients they have a chance to instantly increase their happiness. The higher the Customer Service, the higher the chance will be and also the higher the happiness boost will be (up to +20% without special traits).

Assistants:

Jobs Qualifications

Many skills are useful for janitors and people tend to use them quite differently so my setup below may not fit your playstyle. (Almost) all my janitors take care of everything, I usually don't give them specific assignment. Obviously, since I have only 1 or 2 mechanics per hospital they are the only ones upgrading machine and not taking care of repairs (since others are better for that). Other than that, there is no reason to prevent them from doing other tasks since the game prioritizes machine upgrading anyway.

I find ghosts to be quite annoying, that's why almost all my janitors learn "Ghost Capture" so that anyone can quickly take care of them. A higher move speed is quite useful for janitors too since they spend most of their time walking so except for the mechanic I like to give them the "Motivation" skill. You can definitely replace the Ghost Capture skill with a higher Maintenance skill if you want though for some employees, especially if you micro-manage ghost capture or when your cure rate is good enough with ghosts becoming less common. You can also have janitors with 5 Maintenance skills if you prefer. In this case there is no bad choice it's really up to preference since these skills are all useful.

Janitors:

Jobs Qualifications

Special case :

How to train Roderick, the unique doctor in the first mission of the Culture Shock DLC ?

It's a waste to teach him any treatment skill because once he is level 2, no matter his skills he will have the max possible cure chance with a level 3 machine, and at level 4 he has the max possible cure chance with a level 1 machine.

So I recommend to teach him only General Practice skills to make him the best GP doctor in the game which is the most important employee of the game. In this case, it's also better to not build any X-Ray room during this mission to avoid Roderick from working in a room where he would be less efficient. That way he can work in any room with max efficiency.

Traits Guide - Part 1

When recruiting employees, we can see their level, skills, salary, the recruitment fee but also a list of traits called "Employment Reference". The last line of the traits is always a flavour text that has no gameplay effect at all.

Other traits can all be positive or negative or a mix of both good and bad traits. Moving the mouse over them will display a tooltip giving additional information.

Despite the importance of traits, even 1 year and half after the game's release we don't really know the real effects of most of them. That's why I spent a lot of time experimenting and compiled below the results for each trait with some advice.

Note that there are 4 types of effects:

- Traits only affecting the stats of the employee having it

- Traits affecting other people when talking to them during breaks. Note that these effects don't have 100% chance to activate when talking to someone. The fact that employees sometimes don't interact with others during breaks makes these traits unreliable.

- Traits affecting patients when taking care of them (when diagnosing or dispatching them)

- Traits affecting people around even without talking to them

For the advice I provide for each trait, I will sometimes split employees in different categories:

- Diagnosis staff and receptionists, since they are the ones taking care of patients many traits have a stronger impact for them.

- Janitors are in their own category since they don't spend most of their time working in a room contrary to others.

- Treatment staff and the rest (research doctors, marketing assistants) not taking care of patients. Since treatment is the last step for a patient it's not important that treatment employees give positive or negative buffs to them, so I will consider treatment staff as "not taking care of patients". There is an exception though if you use higher prices for treatment, instant happiness loss or boost from traits are taken into account during the payment process. This can make patients go below or above the happiness threshold that will make them refuse or willing to pay the higher price.

Note that the list is in alphabetic order starting with the positive traits and with the following format:

"Trait name in the employee stat screen (trait name in the recruitment screen) - game description of the trait

Details about the real effects of the trait...

My advice on how good or bad a trait is with more info in some cases..."

POSITIVE TRAITS1. Charming (Charming) - Makes people happier when interacting with them.

The employee with this trait instantly gives +10 happiness to patients when taking care of them.

For diagnosis staff and receptionists: One of the best traits in the game especially if you struggle to keep patients happy.

For the rest of employees: Can be useful for treatment staff if you use higher prices, otherwise not useful at all.

2. Entertainer (Class Clown) - Entertains people with their sweet dance moves.

The employee with this trait instantly gives patients +100 boredom when taking care of them.

The employee also instantly gives patients +80 boredom after talking and dancing for a patient during breaks.

For diagnosis staff and receptionists: Good trait to keep patients from getting bored and thus lose happiness over time.

For the rest of employees: Not really that useful since the effect will only work during breaks giving them time to interact with only a small amount of patients or no patient at all.

3. Cheap (Will work for peanuts) - Reduced salary expectations.

Here is how much a doctor costs in average each year:

Doctor level Cheap trait doctor No trait doctor Expensive trait doctor 1 15 300 $ 17 000 $ 18 700 $ 2 18 000 $ 20 000 $ 22 000 $ 3 21 600 $ 24 000 $ 26 400 $ 4 27 000 $ 30 000 $ 33 000 $ 5 36 000 $ 40 000 $ 44 000 $

For all employees: Cheap is definitely one of the best traits if not the best since one of the most important goals during each mission is to be and stay profitable. Monthly expenses mostly come from wages so this is extremely useful both early and late game.

4. Fast Learner (Has potential) - A quick learner that should develop quickly. +50% Learning Speed

It makes the employee learn new qualification via training faster.

For all employees: A good trait to have since training takes quite a bit of time by default. A bit more useful for medical staff and receptionists to reduce downtime, or to avoid recruiting a temporary replacement while they are training.

5. Funny (Funny) - Makes people laugh.

The employee with this trait can instantly give +40 boredom to the patients they talk to during breaks.

For all employees: Not really that useful since the effect will only work during breaks giving them time to interact with only a small amount of patients, and not necessarily those who need it.

6. Green Fingers (Green Fingers) - Likes to water plants when idle.

The employee with this trait will sometimes water plants when not too busy while working or during breaks.

For all employees: Not an amazing trait but if you use a lot of plants, this could potentially help reduce janitors' workload. However, if the employee is always busy with patients they will only be able to water plants during breaks which means only plants outside working rooms.

7. Healer (Has magic healing hands) - Increases the health of patients.

The employee with this trait instantly gives 5 health to patients when taking care of them.

For diagnosis staff and receptionists: One of the best traits that will help ensure patients don't die before being cured. It's especially great for General Practice doctors since patients can sometimes see them more than once before treatment.

For the rest of employees: Not useful at all. Note that it doesn't matter for treatment either. Even without this trait a patient with 0 health during a treatment can still be cured anyway.

8. Heart-Throb (The girl/boy next door) - The target of unrequited idolization.

Employees with this trait can give patients or employees they talk to a buff called "Has a Crush" which increases their move speed by 15% during a short time.

For all employees: Nothing great, the trait can only activate during breaks and doesn't last a long time.

9. Hygienic (Hygienic) - Likes to stay clean and hygienic.

The employee with this trait passively gains hygiene over time.

For diagnosis staff and receptionists: Not game changing but still a useful trait. When an employee takes care of a patient, the hygiene gauge of both of them gets "equalized". Therefore this trait will not only keep the employee clean but will also help patients stay clean.

For the rest of employees: It's not that useful since hygiene is easy to deal with (sinks in toilets or hand sanitisers in staff rooms for example are more than enough).

10. Inspiring (Inspiring) - Inspires other people.

The employee with this trait can instantly gain and give 5 happiness to the patients or employees they talk to during breaks.

For all employees: Nothing amazing since it seems to only activate during breaks. Maybe this trait has another effect but I couldn't find any.

Traits Guide - Part 2

11. Motivated (Motivated) - Walks faster than normal speed. +20% Speed

It's self-explanatory and increases move speed.

Note that the way move speed works in this game is confusing and can be unreliable because of how move speed buffs/debuffs can "overwrite" each other.

For janitors: One of the best traits for janitors since their work requires them to move a lot.

For the rest of employees: Good.

12. Positive (Positive) - Happiness is higher than average. +10% Happiness

The employee with this trait passively gains happiness over time.

The employee can also instantly gain and give 5 happiness to patients or employees they talk to during breaks.

For janitors: One of the best traits because janitors are usually more difficult to keep happy since they mostly work outside of rooms and often have to deal with things that can lower their happiness.

For the rest of employees: It's easier to keep people in rooms happy because they can benefit from both happiness coming from items increasing attractiveness but also the big happiness boost coming from a high prestige room. It's still a great trait that can compensate the loss of happiness for an employee expecting a higher salary for example.

13. Romantic (Thinks their life is a romcom) - Constantly falling in and out of love.

The employee with this trait can instantly gain and give the patients or employees they talk to during breaks, 30 happiness and a temporary buff called "In Love" which increases their move speed by 15% during a short time.

For all employees: It's not incredible since it seems to only activate during breaks but the buff and the big happiness boost are still nice to have.

14. Teacher (A natural mentor) - Whizzes through any syllabus. +50% Teaching Speed

The employee with this trait trains other employees faster.

For all employees: A good trait to have on one high level person per job type to train other employees faster than the guest trainer and without the extra cost.

15. Tireless (High Energy) - Works longer before needing a break.

Here is how many days employees work by default before taking a break:

Lazy trait = 112 days

No trait = 134 days

Lazy trait + Stamina skill = 141 days

Tireless trait = 168 days

No trait + Stamina skill = 178 days

Tireless trait + Stamina skill = 243 days !

As we can see, this trait combined with the Stamina skill is insane and allows 243 days of work before taking a break.

Note that even though it's amazing, a potential downside is that the needs of the employee will be very low before the break is taken. This means the employee will probably get some "unhappiness" debuff that could be an issue if not properly managed.

For janitors: Good trait but be careful, it can be counter-productive for janitors. They usually struggle with happiness and having them work longer means their happiness will dangerously drop sometimes. It's probably better to recruit tireless janitors only if they also have the "Positive" trait. It's also manageable if your hospital has green attractiveness everywhere. If you have trouble keeping tireless janitors happy enough, you could also increase their pay... but no more than +20% otherwise it's not worth it and it's probably better to get rid of them.

For the rest of employees: One of the best traits to have and even if some employees have the Stamina skill as well it's easier in high prestige rooms to keep them happy contrary to janitors. Their hunger/thirst needs can also be satisfied with Sweet Dispenser and Coffee Maker for example if they are not always busy.

NEGATIVE TRAITSEven though some negative traits aren't that bad or can easily be worked around, I still recommend to avoid them if possible. There is no point in keeping (or recruiting) an employee with bad traits when you can replace them with people who have good and useful traits and do the same job better in the end.

16. Argumentative (Likes to Argue) - Argues with other argumentative people.

The employee with this trait talking to another character with the same trait during breaks makes both of them instantly lose 5 happiness.

For all employees: Not really a big deal in my opinion since it only affects 2 characters with the argumentative trait and only during breaks. If you have only one employee with this trait it's more a neutral trait.

17. Boring (Terribly dull) - Makes people bored.

The employee with this trait instantly reduces the boredom gauge of patients by 80 when taking care of them.

For diagnosis staff and receptionists: Very bad trait to have especially on a receptionist or GP doctor since it means the patient will be unhappy much faster.

For the rest of employees: Not a big deal since they don't take care of patients.

18. Dirty (Dirty Habits) - Makes the hospital dirty.

Sometimes, the employee with this trait will not wash hands when getting out of the toilets.

For all employees: Surprisingly, the trait doesn't seem to be as bad as it sounds. I am suspecting it has other less obvious effects but I couldn't find any. It's possible that it affects epidemics or VIP visits but it's not something that can easily be checked.

19. Expensive (Wants more money) - High salary expectations.

Here is how much a doctor costs in average each year:

Doctor level Cheap trait doctor No trait doctor Expensive trait doctor 1 15 300 $ 17 000 $ 18 700 $ 2 18 000 $ 20 000 $ 22 000 $ 3 21 600 $ 24 000 $ 26 400 $ 4 27 000 $ 30 000 $ 33 000 $ 5 36 000 $ 40 000 $ 44 000 $

For all employees: Expensive is one of the worst traits in the game and can make you struggle to be and stay profitable. Monthly expenses mostly come from wages so never recruit an employee with this trait.

20. Evil (Has a dark side) - Enjoys doing evil things.

The employee with this trait instantly reduces health of patients by 5 when taking care of them.

For diagnosis staff and receptionists: Obviously, one of the worst traits that you should avoid at all costs. Health for some illness decreases at a very high speed so having this trait will make it even more difficult to cure patients before they die.

For the rest of employees: Not a big deal since they don't take care of patients.

21. Gross (Nausea inducing) - Makes people feel sick.

The employee with this trait can make people around slightly more likely to vomit.

For all employees: Note that it's not really possible to say how bad this trait really is since the sickness effect that makes people vomit is some kind of hidden stat. Still, it's bad to have this trait especially in a crowded hospital.

22. Grumpy (Grumpy) - Happiness is lower than average. -10% Happiness

The employee with this trait will passively lose (more) happiness over time.

For all employees: It's one of the worst traits, especially for janitors. This makes it more difficult to keep happiness above 80% to enjoy the stats boost provided by the "Happy" buff.

Traits Guide - Part 3

23. Hangry (Hangry) - Becomes nasty when hungry. -10% Happiness

When Very Hungry (hunger gauge below 20%):

- the employee with this trait gains an extra debuff called "Hangry" that lowers happiness over time.

- the employee also reduces happiness of patients by 5 when taking care of them.

- this can also make the employee instantly reduce happiness by 10 of patients or employees they talk to during breaks.

- finally, the employee will occasionally have nasty outburst making nearby people get the "Annoyed" debuff. It lasts a very short time and seems to slightly lower happiness over time.

For all employees: All these effects make it a dangerous trait to have. Fortunately, hunger is not that hard to satisfy.

24. Lazy (Tires easily) - Wants more frequent breaks.

Here is how many days employees work by default before taking a break:

Lazy trait = 112 days

No trait = 134 days

Lazy trait + Stamina skill = 141 days

Tireless trait = 168 days

No trait + Stamina skill = 178 days

Tireless trait + Stamina skill = 243 days

For all employees: One of the worst traits since you pay an employee as much as others to work less.

25. Litterer (Litterer) - Drops litter around the hospital.

The employee with this trait regularly throw trash on the ground despite the presence of bins.

For janitors: Not a big deal for them since they can only throw trash during their breaks.

For the rest of employees: Since this forces janitors to come clean even when they are far away and needlessly increases their workload, this is not a trait you want in your hospital.

26. Nasty (Nasty) - Upsets other people.

- The employee with this trait can instantly reduce happiness by 10 of patients or employees they talk to during breaks.

- When happiness is between 20 and 40%, the employee reduces happiness of the patients by 2 when taking care of them.

- At 20% happiness or below, the employee reduces happiness of the patients by 4 when taking care of them.

- Finally, the employee will occasionally have nasty outburst making nearby people get the "Annoyed" debuff. It lasts a very short time and seems to slightly lower happiness over time.

For all employees: Very bad trait to have...

27. Short Temper (Short Temper) - Becomes nasty when unhappy.

- When happiness is at 40% or below, the employee with this trait can instantly reduce happiness by 10 of patients or employees they talk to during breaks.

- When happiness is at 40% or below, the employee will occasionally have nasty outburst making nearby people get the "Annoyed" debuff. It lasts a very short time and seems to slightly lower happiness over time.

- When happiness is between 20 and 40%, the employee reduces happiness of the patients by 5 or 10 when taking care of them (5 in GP office but 10 in reception for some reason).

- At 20% happiness or below, the employee reduces happiness of the patients by 12 when taking care of them.

For all employees: Just like Nasty, it's a very bad trait to have but can be manageable for staff working in rooms since its effects only activate when the employee has happiness below 40%.

28. Sleepy (Suffers from spontaneous bouts of snoozing) - Will fall asleep, at random, every now and then.

The employee with this trait will sometimes fall asleep during a short time when not busy (and only during breaks for janitors).

For all employees: Can be annoying but isn't that terrible since in the end what it does is mostly make employees "lose" some time during breaks.

29. Stupid (Cheese for brains) - A slow learner that will take some time to develop. -25% Learning Speed

It makes the employee learn new qualification via training slower.

For all employees: Not great since it makes the employees become unavailable during a longer time especially if it's someone you want to ultimately give 5 skills. However, staff slowly gets energy while training so the longer course duration means more energy when it's complete which somewhat compensates a little.

30. Toilet Rage (Gets toilet rage) - Gets angry when they need the toilet. -10% Happiness

When desperate for the toilet (toilet gauge below 20%):

- the employee with this trait gains an extra debuff called "Toilet Rage" that lowers happiness over time.

- the employee also reduces happiness of patients by 5 when taking care of them.

- the employee will occasionally have nasty outburst making nearby people get the "Annoyed" debuff. It lasts a very short time and seems to slightly lower happiness over time.

For all employees: The decay speed of the toilet gauge varies a lot and is for example much faster after drinking/eating. Overall it still goes down fast so this trait is very bad.

31. Unhygienic (Unhygienic) - Doesn't wash their hands.

The employee with this trait passively loses hygiene faster than others.

The employee won't wash hands at all when getting out of the toilet.

Since going to the toilet instantly reduces hygiene by 10 and taking care of patients can lower it even more, the gauge will eventually fall to 0. Fortunately, unhygienic employees still use hand sanitisers so make sure to have some in the staff rooms for example.

For diagnosis staff and receptionists: It's not a good idea to have this trait since a low hygiene employee will "spread" it to patients they take care of.

For the rest of employees: It's hard to really tell how bad it is for employees not managing patients, it probably doesn't help in case of epidemics so just avoid it anyway.

32. Unmotivated (Unmotivated) - Walks slower than normal speed. -20% Speed

It's self-explanatory and decreases move speed.

Note that the way move speed works in this game is confusing and can be unreliable because of how move speed buffs/debuffs can "overwrite" each other.

For janitors: One of the worst traits for janitors since their work requires them to move a lot.

For the rest of employees: Quite bad too even though buffs like Happy/Energised that increase move speed can compensate it.

33. Weak Bladder (Weak Bladder) - Needs the toilet more often than most.

The employee with this trait has the "toilet" gauge deplete around 5 times faster than normal.

This means that the happiness loss for needing the toilet will show up sooner. The happiness loss is negligible when the gauge is above 20%, however below 20% the loss over time is at -10%.

For all employees: Very bad trait, especially for janitors.

To conclude this traits guide, these are in my opinion the best ones:

- For all employees: Cheap (Will work for peanuts), Positive, Tireless (High Energy)

- For diagnosis staff and receptionists: Charming, Healer (Has magic healing hands)

- For janitors (but still fine for other employees too): Motivated

Staff Marketing Campaigns

Having more than 1 marketing assistant in a room boosts the effect of marketing campaigns. It works for reputation campaigns (reputation gained faster) and also for staff campaigns (less time until next applicant shows up).

Here is a video of what it looks like to have 7 marketing rooms with 5 employees launching the same doctor campaign:

https://www.youtube.com/watch?v=6g8e8_i2M-A

Note that "specialist" campaigns are different from the "basic" staff campaigns.

If you do a "Psychiatrist Campaign", it doesn't lower the time for new applicants to arrive, instead it increases the chance for the next applicant to have the desired specialist skill (the "Psychiatry" skill in this example). However, if you have 2 marketing rooms, you can combine a basic "Doctor Campaign" and a specialist campaign to make those specialists show up more quickly.

For reference, I tested a "Psychiatrist Campaign" in 4 marketing rooms at once. For the 60 doctors that showed up during the test, 13 of them were juniors (meaning they had no skill at all), all the rest sometimes had various qualifications with always at least a psychiatrist qualification.

The specialist campaigns seem to only change an existing skill of the next applicant to the desired one. That's why there will still be junior staff to recruit from time to time... Since they have no skill, the special campaigns can't replace anything. This isn't necessarily a bad thing since juniors are cheaper in the long run and you can just train them however you like.

Research Formula And Calculator

A. Formula

First, let's talk about how research works.

Here is the formula that is used by the game to calculate the research rate :

(Research Skill from all researchers) * (1 + (Research Power multiplier from all items / 100)) / 100 = Research Points per second at normal speed

Let's have an example using this formula... Just as a disclaimer when I say for example "a level 4 researcher", it always means a level 4 doctor who already learned Research IV skill.

2 level 5 researchers and 1 level 4 researcher are working in my research room. There are 12 Super Computers in the room and there is also 1 Researcher's Desk that is mandatory to create the room.

- Research Skill value of a level 5 researcher = 320, but to take into account the Energised buff during a full shift, let's add 2.5% to it = 322.5

- Research Skill value of a level 4 researcher = 262.5

- Research Power from the 12 Super Computers = 12 * 2 = 24

- Research Power from the mandatory Researcher's Desk = 1

Now if we apply the formula :

(322.5 + 322.5 + 262.5) * (1 + 25 / 100) / 100 = ~11.34

This team generates 11.34 research points per second at normal game speed.

B. Calculator

With this knowledge and the fact that 1 in-game day lasts 4 seconds in normal speed we created a calculator to properly simulate research based on multiple variables:

https://docs.google.com/spreadsheets/d/13u7M5PG-CyJoJXhlYVhPM_6mSPoHqWSe1WiV8kKEb90/edit?usp=sharing

In case you want to use/modify it, just make a copy of the spreadsheet ("File" > "Make a copy"). I recommend to only change the cells in green since the rest of the sheet dynamically changes based on their values.

C. Experience

Surprisingly, a researcher seems to earn some XP only when they interact with the Research Pod (2 or 4 XP per interaction) or a Researcher's Desk (2 XP per interaction).

Since Servers and Super Computers can trigger an animation that make doctors lose time, it's bad to have them in the room if you want the researchers to level up fast. Research Monitors and Science Stations don't trigger an animation so they are fine. Having a big room can be harmful though since the researchers can lose time moving instead of using the 2 items providing XP.

Note also that 3 researchers can use the Research Pod at the same time so in a room of 5 employees leveling up it's probably a good idea to add an extra Researcher's Desk so that they can all interact with something at the same time and earn some XP.

Money Research Project Analysis

A. Is it worth it to use research to earn money ?

Thanks to the calculator[docs.google.com] , it's quite easy to answer this question. Yes, it can be very profitable with the proper setup.

First, let's talk about items boosting the Research Powers. Note that Research Monitors, Researcher's Desk, Servers and Super Computers all have a monthly energy cost and can potentially make the player lose money instead of helping.

Therefore, only use Research Monitors, Researcher's Desks or Super Computers when :

- you have a solo researcher at level 4 at least

- or 2 researchers at level 2 or above

- or 3 researchers with at least one at level 2

- or when there are more than 3 researchers

Never use Servers unless :

- you have at least 2 researchers at level 4

- or 3 researchers with at least 2 of them at level 3 and one at level 2

- or 4 researchers with at least 3 of them at level 2

- or 5 researchers with at least 2 of them at level 2

Keep in mind Servers are quite inefficient since the Research Power they provide is twice as costly per month as other boosting items. There is no reason to use Servers at all once you unlock Super Computers. Even before that, it might be better to rely on other items.

An important thing to note is that the Science Station (from Close Encounters DLC) doesn't have any energy cost and is very cheap, so you can use it anytime if you want even though it's quite big for just 1% Research Power.

These boosting items can significantly reduce the time it takes for researches to complete and make research very profitable in the long term. Just use the calculator to see how much impact will have the addition of some items for your setup.

Except the Science Station, these items are all very expensive though. That said, if you have spare money it's still better to place some of these objects than having money sleep for nothing. If you need money, you can still sell them anyway to get your money back. Something else to be aware of is that "Servers" and "Super Computers" also increase temperature around them.

B. Profitability per project completion

Here is how much money is gained in average after completing the "General Research" money project with 1, 2 and 5 doctors with the skill from research I to research V. Days displayed are the number of days it takes to complete the project including break days. No items are used.

1 level 1 doctor (~345 days) = 1 803$

1 level 2 doctor (~200 days) = 7 403$

1 level 3 doctor (~141 days) = 9 301$

1 level 4 doctor (~109 days) = 9 737$

1 level 5 doctor (~89 days) = 9 042$

2 level 1 doctors (~173 days) = 2 370$

2 level 2 doctors (~100 days) = 7 731$

2 level 3 doctors (~71 days) = 9 532$

2 level 4 doctors (~55 days) = 9 915$

2 level 5 doctors (~45 days) = 9 187$

5 level 1 doctors (~69 days) = 2 710$

5 level 2 doctors (~40 days) = 7 928$

5 level 3 doctors (~29 days) = 9 671$

5 level 4 doctors (~22 days) = 10 022$

5 level 5 doctors (~18 days) = 9 274$

As we can see researchers become much more "efficient" at level 3 or above.

If you intend to make money with research, try to recruit doctors with the "Cheap" trait and reduce their expected salary during promotion. Researchers aren't really more efficient when happy contrary to medical staff, so just make sure their happiness is above 20%, otherwise it doesn't matter.

C. Long term profitability

As pointed out by Nspace, the above chapter only takes into account the profitability for only one research project. Here is on average how profitable each group of doctors will be in the long term. Let's take a time span of 5 years (1 825 days).

1 level 1 doctor = 9 542$

1 level 2 doctor = 67 679$

1 level 3 doctor = 120 835$

1 level 4 doctor = 163 971$

1 level 5 doctor = 187 068$

2 level 1 doctors = 25 085$

2 level 2 doctors = 141 358$

2 level 3 doctors = 247 670$

2 level 4 doctors = 333 943$

2 level 5 doctors = 380 136$

5 level 1 doctors = 71 712$

5 level 2 doctors = 362 394$

5 level 3 doctors = 628 176$

5 level 4 doctors = 843 857$

5 level 5 doctors = 959 339$

Since 5 level 5 doctors can research much faster, they are ultimately the most profitable research group. The issue with 5 level 5 doctors is that it will require a lot of micro management, since you will have to start a new project every 18 days or so. Obviously, make sure to instantly pause the game as soon as a project is finished to start a new one and thus avoid paying doctors and energy for nothing.

In any case, don't forget that it's not cheap in terms of money/time to train these doctors so keep that in mind.

D. Initial costs

The initial cost of the construction of the room, the recruitment fees of the doctor(s) and the training costs mean it will take time for research to really become profitable.

If we include those costs for the solo level 4 doctor we have:

Research room price = 35 100$

Recruitment fee = 1 650$

Research I training = 15 000$ + 37 days of training by default

Research II training = 20 000$ + 42 days of training

Research III training = 25 000$ + 46 days of training

Research IV training = 30 000$ + 50 days of training

Salary during the 37 days of training = 1 724$

Salary during the 42 days of training = 2 302$

Salary during the 46 days of training = 3 025$

Salary during the 50 days of training = 4 110$

35 100 + 1 650 + 15 000 + 20 000 + 25 000 + 30 000 + 1 724 + 2 302 + 3 025 + 4 110 = 137 911$

As you can see, 137 911$ is quite an investment... Let's see how many level 4 campaigns are needed to repay this investment.

A campaign lasts around 109 days if we include break days. We get around 9 737$ per campaign.

137 911 / 9 737 = ~15

It takes 15 research projects to pay the investment. This means we need 5 years of research to repay the initial investment with level 4 campaigns, it's obviously more than that if we take into account early campaigns made before the doctor reaches level 4.

If you have more than 1 researcher, make your own doctor train the others so you can at least reduce the costs there. Having more researchers will help to quickly repay the investment.

Finally, if you play the Bigfoot DLC, it unlocks more money research projects in the campaign (doesn't seem to be available in the sandbox mode though). "Roderick's Plot Hole" is the best project to do, "Cheesier Gubbins" is the second best but it has the advantage of requiring slightly less micro-management since it takes longer to research.

E. Conclusion

Even though you can earn a lot of money with 5 researchers, it's not always worth the effort to have a research room dedicated to earn money if you already know how to make a profitable hospital. However, it can still help a lot especially if you manage to get a team of 5 cheap researchers. In the long term 5 level 5 researchers are better but just keeping them at level 3 for example is acceptable thanks to lower training costs and they will require less micro-management.

As an income comparison, the base price of most treatments is between 5 000 and 12 000$. So with just 1 or 2 treated patients per month you can gain more or less the same amount of money as a money project. However, the good thing about the research room is that you can get a steady income not depending on how the rest of your hospital performs. This is especially useful in the missions with public hospitals where patients don't give money (or less money) and during the wave missions where income can suffer a lot while waiting for the next wave of patients.

A disadvantage or advantage depending on the situation is that building the research room and recruiting doctors increase the hospital level. This means that it can make more patients come to the hospital which can be an issue if not ready to manage them.

Energy Cost

Staff wages are paid at the start of each month along with the energy bill.

Contrary to wages, there is not much the player can do to efficiently reduce the energy bill. Fortunately, the amount is relatively small in most cases so what you will read below is more informative than "useful".

However, an important thing to note is that not only items boosting research power are very expensive, they also cost money each month. So if you do research, you should be careful since it can massively increase the energy bill if you use too many of them. There is an exception though, "science station" from the Close Encounters DLC is a research boosting item that doesn't cost any money each month and is also quite cheap, but takes much more space than supercomputers.

Here is below the energy cost per month of all items. If any of these items is in the hospital at the end of the month then it will be taken into account in the monthly energy bill:

- 3$ per snacks, fruits, vegetables and drinks machine / arcade machine / arm bot / charging point / test-your-strength / vanity chamber / trampoline / gum dispenser / vaulting box

- 10$ per wall monitor / pin art / accordionatron / velocipede / frozen art /

- 15$ per ice sculpture

- 20$ per pinball machine

- 25$ per small radiator / small aircon unit

- 30$ per incinerator / wall aircon unit / shark bin

- 50$ per radiator / furnace / aircon unit / mini radiator / hologram / fireplace / researcher's desk / research monitors

- 75$ per large radiator

- 100$ per supercomputer / server / deep thing 1 / deep thing 2

For "cosmetic" items, only the following ones seem to cost money each month:

- 3$ per cryptohedron

- 5$ per lamp / lava lamp / circus lights / torch

- 10$ per television / retro TV / space cowboy / some keys / floppy clock / fossil / fitzpocket statue / cheesewater statue / gazplank statue / black & white / fascinator / orrery / maestropod / silver fox / pine cone / bust / armless statue / hypercube / puzzling cubes / blob fish / rocket pig / swinging balls / cat person / ex-lizard / bone lizard / mount facemore / dog portrait / ghost mirror / speaker stack / pool toy / origami / golden statuette / giant glass / shark art / jewel / grandfather clock

- 50$ per indoor fountain / large fountain / dolphountain / love statue / golden gubbins and... ski rack for some reason

For rooms, it's more complicated. There is no energy bill for rooms when they aren't used. There is an exception with the research room that costs 100$ each month by default (even when nothing is researched).

For diagnosis and treatment rooms with a machine, they increase the energy bill based on the number of patients that are processed each month and the energy cost depends on the room itself. The energy bill increases by 100$ for each patient that was processed for example in the General Diagnosis and Pharmacy rooms. In other rooms like Fluid Analysis, DNA Lab, Mega Scan, etc the energy cost is higher with 250$ per processed patient. Note that I didn't check all rooms so it's possible other rooms have different costs per processed patient but it doesn't really matter since nothing can be done to change that.

Rooms without a machine (GP office, Ward, Psychiatry...) that I checked don't seem to increase the energy bill at all even when processing patients.

Interesting Unlockable Items

I will list below the items I use the most or at least that may be worth unlocking with Kudosh in my opinion. I am only talking about items that affect gameplay significantly enough.

General Items:

Luxury Snacks Machine - K300 - $2 000

A snack machine that also increases happiness so it's obviously quite useful. Snack and drink machines that increase happiness are obviously the best choice if you have patients rage quitting because of happiness falling to 0. They are also probably the best too if you tend to increase treatment prices in your hospital (patients with high enough happiness won't refuse to pay high prices when cured). Fancy Food Machine from Culture Shock DLC is a much more powerful version of this item but has the downside of massively increasing thirst.

Amusing Snack Machine - K500 - $2 000 (Pebberley Island DLC)

A snack machine that also reduces boredom, a 2-in-1 item that can somewhat replace other items that reduce boredom of the patients making it a powerful machine. However, note that boredom isn't something employees have to worry about, so it will just be like a normal snack machine for the staff using it.

Absorbent Snack Machine - K500 - $2 000 (Bigfoot DLC)

A snack machine that also reduces the toilet need but increases thirst. The thirst increase is around 10% while the toilet reduction is random at either 15% or 100%. With this, it's easier to run a hospital without building any toilet or just to have patients/staff go to the toilets less frequently.

Luxury Drinks Machine - K300 - $2 000 (unlocked in Tumble with 3 stars)

A drink machine that also increases happiness so it's very useful. Just like the snacks version, it's usually the best to use especially if you increase medical prices.

Laxative Drink Machine - K500 - $2 000 (Pebberley Island DLC)

Very powerful item but with a drawback that can be bad depending on the hospital layout. It makes the patient's health increase over time while the toilet gauge decreases at a much higher speed. An issue with this machine is that your staff don't care about the health increase but will still get the toilet gauge decreasing faster if they use it. It's probably not worth it most of the time, however if you have many patients dying before treatment it's definitely an item that can help.

Energy Drinks Machine - K200 - $1 000

A drink machine that also provides a temporary move speed boost. If happiness/health isn't an issue for you, it's a good drink machine.

Water Cooler - K200 - $400 (Close Encounters DLC)

A very cheap and small drink machine that never needs to be refilled by a janitor. It can be very useful to reduce their workload even though I prefer using other items that provide a bonus. Note that the Drinking Fountain is a very similar item that is slightly cheaper and don't require any DLC but has the downside of lowering hygiene by 4% when used which is acceptable.

Sweet Dispenser - K45 - $300

Small item that can also be placed in work rooms. If a staff member is hungry and not busy (meaning no patient queuing at all), they can satisfy their hunger need thanks to this. Note also that contrary to most other food machines, it doesn't need a janitor at all.

Replication Station - K200 - $2000 (A Stitch in Time DLC)

Patients can use it both to drink or to eat so it can save space to only have this item. When using the machine to either drink or eat, it even has a good chance to take care of both hunger and thirst at the same time. Sometimes, it instantly decreases or increases health of patients by 5 or 10%. Its maintenance gauge is only reduced when it's used to drink. A downside of this item contrary to other drink/food machines is that disasters can reduce its maintenance gauge.

Big Bin - K20 - $100

There is no reason to use the normal bin after unlocking this one and it's cheap so get it early. The toxic-waste bin (and shark bin from Culture Shock DLC) have some advantages regarding hygiene and attractiveness but are smaller bin.

Hand Sanitiser - K150 - $200

Useful to keep everyone clean. In case you have unhygienic employees, they don't wash their hands when getting out of the toilets but they still use Hand Sanitisers.

Ice Sculpture - K75 - $300 (Pebberley Island DLC)

It makes the missions with hot climate much easier to manage. The issue with air con units is that they often require maintenance from janitors while the sculpture doesn't need any. Note that the Frozen Art item from Culture Shock DLC is a similar item with a stronger effect but is very expensive and can't be placed in most rooms so its overall less interesting.

Gold Star Award - K200 - $300

It's the best item to increase the prestige level of a room. It allows to easily reach room prestige level 5 even in a 3 x 3 room.

Brain Jar - K800 - $1 000 (Close Encounters DLC)

Useful one-square item if you want to increase attractiveness of an open area (for other areas, putting decorations on walls is usually enough). It's more reliable than plants since it doesn't need maintenance.

Bulging Sack - K400 - $500

I didn't try using it during a whole mission but it seems to be an very powerful item. It increases happiness by +40% when interacting with it which is extremely good...

Throne - K500 - $800 (Culture Shock DLC)

It's a chair that increases attractiveness around itself in an area that is quite big. But the most interesting aspect of it is that it also instantly increases happiness by 20% when a person sitting on it gets up (even after sitting just 2 seconds). I don't often use benches/chairs for patients because it tends to make them lose time, but if you do this item is amazing. The biggest downside is obviously the high price.

Room Items (not visible in the general list of items):

Hot Chocolate Maker - K400 - $300 (Bigfoot DLC)

If a staff member is thirsty and not busy (meaning no patient queuing at all), they can satisfy their need thanks to this. It also provides a happiness boost.

Coffee Maker - K200 - $300

If a staff member is thirsty and not busy (meaning no patient queuing at all), they can satisfy their need thanks to this. It provides a temporary move speed boost, it's not incredible but still cool.

Diagnosis and some treatment rooms:

Medicine Cabinet - K400 - $1 000

Good item to fill empty space of a room with something that isn't just cosmetic. Increased diagnosis and treatment power is useful and better than nothing anyway. If you have the Retro Items Pack DLC, it's unnecessary to unlock the Medicine Cabinet since it contains a similar item called Weighing Machine. In comparison, it only costs $400 and the placement shape is a square instead of a "rectangle".

Surgery, both Wards and Cardiology:

Wall Monitor - K125 - $500

Just like the Medicine Cabinet, it increases diagnosis and treatment power but this one can be placed on walls. So having some in rooms is nice.

Toilets:

Golden Toilet - K40 - $2 000

4 times more expensive than normal toilet but can be worth it once you can afford it. Take a look at the "Differences between toilets" chapter to see why it's good and how to unlock it.

Training room:

Anatomy Poster - K80 - $100

Cheap, small, can be placed on walls and speeds-up training.

Encyclopedia Bookcase II - K800 - $4 000 (unlocked in Mitton University with 2 stars)

Big boost to the training speed for a relatively small item. If you have extra money, just fill the training room with this item. If you need money, you can still sell the bookcases and get your money back so it's never wasted money. It's more expensive than the Anatomy Model but from a training bonus per used space perspective, the Bookcase II is better in most cases (make sure to hold the "Ctrl" key to put them close to each other).

Illnesses And Diagnosis Modifiers - Part 1

The diagnosis percentage obtained when a patient is diagnosed depends on those 3 following factors and there is no randomness involved at all in the process:

- The diagnosis skill of the doctor or nurse.

- The level of the machine and the bonus provided by items like medicine cabinets. Bonuses stack so many medicine cabinets can be used if you want.

- The last factor is the room modifiers shown in the table below and that aren't really visible in-game, as you can expect this means that some rooms are better than other to diagnose different illnesses.

With Felgard's help, data for all illnesses and more could be gathered.

So here is the list of all in-game illnesses with diagnosis modifiers and also the treatment modifiers (a low percentage means it's difficult to cure). The list also includes the "revisit " modifier used whenever a patient visits a office more than once.

Revisit 10%12%12%12%12%12%9.9%50%80%12%7%7%12%12%16%60%85%5%21.80%15%15%15%15%8.75%60%22%7%22%22%22%22%22%15%60%50%15%15%15%15%15%9%50%1000%---------90%12%7%12%12%12%5%10%10%10%10%8.4%50%7%12%12%12%15%12%4.8%10%10%10%10%10%10%60%12%12%12%12%10%8%8%8%18%15%9%60%10%10%10%10%10%10%50%55%15%15%15%15%15%15%11%70%50%17%7%17%17%10%60%1000%---------100%15%7%7%7%10%10%15%10%7.5%10%10%5%10%90%7%22.5%80%60%7%18%18%18%18%13.2%70%Revisit

Illnesses And Diagnosis Modifiers - Part 2

Revisit 15%15%15%15%15%15%15%10%15%10%10%10%10%10%11.60%15%15%15%6%60%Jumbo 15%10%10%10%10%10%10%9%80%5%12%70%10%10%10%10%10%10%90%15%15%15%15%15%15%15%15%9%80%15%15%7%7%18%15%15%11.5%5%5%5%5%3%18%18%18%18%18%9%60%60%12%90%31.5%80%15%15%15%15%15%10%80%7%7%16%70%8.75%15%15%15%15%15%12.5%70%15%15%13%15%15%7%70%8%8%8%10%10%6%75%5%15%60%5%28%10%10%10%10%10%8.4%15%5%5%5%15%5%7.5%24%7%9%60%12%7%12%12%12%5%5%15%5%5%5%10%8%8%8%18%18%18%15%11.70%10%15%5%5%5%5%5%10%9%9%9%9%9%8%15%7%15%15%9%100%75%Revisit

Here is an example to understand how to interpret/use those data.

A patient with "Emperor Complex" arrives in the hospital and visits a basic office. The doctor there has a diagnosis skill of 80% (stat is visible in the UI in-game). In the table above, has a value of for this illness.

20 x 80% = 16 Patient now has been diagnosed at 16% and is sent to the General Diagnosis that has a level 3 machine (+ diagnosis power). In the table above, the value for "Emperor Complex" is 12%. The nurse working there has a diagnosis skill of 1.

12 x 1 = 18

18 x 1.5 = 27

16 + 27 = 43 Patient now has been diagnosed at 43% and is sent back to a office. The doctor in the office was replaced with someone much more competent and has a diagnosis skill of 165%. In the table the revisit value is 10%.

10 x 165% = 16.5

43 + 16.5 = 59.5 Patient now has been diagnosed at 59.5% (60% in-game) and continues his long journey in the hospital...

Note that according to Mavocide: "The numbers are never rounded internally, the UI does rounding for display purposes only." This is why diagnosis values shown in game are always integers.Mavocide also provided additional info on how to take into account medical cabinets: "Item bonuses such as medicine cabinets are added to machine upgrades, so a tier 3 machine and 5 cabinets would create a single 1.55 multiplier."

I purposely shown separated calculations in my example, but you can just use Mavocide's formula below to easily get the % diagnosis that will be obtained by a patient in a room:

StaffDiagSkill% * RoomModifier% * RoomUpgrade%

Char limit on Steam forced me to divide the table, you can find the whole one here if necessary:

https://www.reddit.com/r/TwoPointHospital/comments/9husy9/full_illnesses_and_diagnosis_modifiers_finally/

Spreadsheet:

https://docs.google.com/spreadsheets/d/1TK9FKIUvC_bSgLTKgYwKA1DEE7HasQWpBd7s9IkdpDs/edit

Bigfoot DLC Illnesses Modifiers

Here are diagnosis modifiers for all illnesses from the Bigfoot DLC.

Something interesting is that it's the first time an illness can't be diagnosed at all in a room. Patients afflicted with and will never go to a .

Revisit 8.75%15%10%10%10%10%10%11.15%15%15%15%8.75%80%12%7%7%12%12%16%60%90%22.5%75%8%8%8%18%18%18%15%11.70%15%15%15%15%15%15%15%10%60%7%18%18%18%18%13.2%70%55%15%15%15%15%15%15%11%70%8%8%8%18%15%9%60%5%7%12%12%12%15%12%4.8%12%7%12%12%12%5%8%8%8%10%10%6%15%10%10%10%10%10%10%9%80%7%7%16%70%60%22%7%22%22%22%22%22%15%60%15%7%7%7%10%10%15%10%7.5%10%10%10%10%10%10%60%15%15%15%15%15%9%12%12%12%12%10%90%7%22.5%80%15%7%-15%9%10%10%10%10%10%8.4%18%18%18%18%18%9%60%15%15%7%7%18%15%15%11.15%7%-15%9%10%10%10%10%10%10%5%5%5%5%5%3%15%15%15%15%15%10%60%12%10%10%10%10%10%10%17%24%7%17%17%17%9%60%75%5%15%60%Revisit

You can use the "mega spreadsheet" below to interact with those modifiers. Just make a copy of the spreadsheet to be able to change the staff level and upgrades settings:

https://docs.google.com/spreadsheets/d/1TK9FKIUvC_bSgLTKgYwKA1DEE7HasQWpBd7s9IkdpDs/edit?usp=sharing

Pebberley Island DLC Illnesses Modifiers

Here are diagnosis modifiers for all illnesses from the Pebberley Island DLC.

It's worth noting that illness can't be diagnosed by wards at all.

Two illnesses from this DLC can have a negative effect on your hospital and give more work to your janitors. Patients afflicted with regularly "pee" on the ground. Patients afflicted with can be "dangerous" since they have a chance to make people around them vomit.

Revisit 18%18%18%18%18%9%60%15%15%15%15%9%55%8%8%8%18%18%18%15%11.70%15%10%10%10%10%10%10%9%-5%12%7%12%12%12%5%7%12%12%12%15%12%4.8%80%5%12%70%8%8%8%18%15%9%60%15%15%15%15%15%6.60%17%24%7%17%17%17%9%60%15%15%15%8.75%60%12%75%5%15%60%15%7%7%7%10%10%15%10%7.5%10%10%10%10%10%10%15%15%15%15%15%9%10%10%10%10%10%10%12%7%12%12%12%5%60%7%18%18%18%18%13.2%70%8.75%5%5%5%5%5%3%12%12%12%12%10%80%7%7%16%70%8%8%8%10%10%6%15%5%5%5%15%5%7.5%100%75%15%10%10%10%10%11.10%10%10%10%10%8.4%60%7%15%60%15%15%15%15%15%15%15%10%15%15%15%15%15%10%10%12%12%12%12%12%9.9%15%15%7%7%18%15%15%11.Revisit

You can use the "mega spreadsheet" below to interact with those modifiers. Just make a copy of the spreadsheet to be able to change the staff level and upgrades settings:

https://docs.google.com/spreadsheets/d/1TK9FKIUvC_bSgLTKgYwKA1DEE7HasQWpBd7s9IkdpDs/edit?usp=sharing

Close Encounters DLC Illnesses Modifiers

Here are diagnosis modifiers for all illnesses from the Close Encounters DLC.

Revisit 7%12%12%12%15%12%4.8%10%15%5%5%5%5%5%80%7%7%16%70%8%8%8%18%18%18%15%11.70%15%15%15%15%7.5%18%18%18%18%18%9.9%60%60%7%18%18%18%18%13.2%70%17%24%7%17%17%17%9%60%8.75%8%8%8%10%10%6%60%7%15%60%60%12%15%15%15%15%9%55%10%12%12%12%12%12%9.9%10%10%10%10%10%10%10%10%10%10%10%10%60%80%5%12%70%5%5%5%5%5%3%15%10%10%10%10%10%11.5%15%15%15%15%8.75%10%9%9%9%9%9%8%15%10%10%10%10%10%10%9%10%10%10%10%10%8.4%100%75%12%7%12%12%12%5%10%10%5%10%75%5%15%60%8%8%8%18%15%9%60%12%12%12%12%10%15%15%15%15%15%9%12%7%12%12%12%5%10%10%10%10%10%10%15%7%7%7%10%10%15%10%7.5%15%15%15%15%15%10%Revisit

You can use the "mega spreadsheet" below to interact with those modifiers. Just make a copy of the spreadsheet to be able to change the staff level and upgrades settings:

https://docs.google.com/spreadsheets/d/1TK9FKIUvC_bSgLTKgYwKA1DEE7HasQWpBd7s9IkdpDs/edit?usp=sharing

Off The Grid DLC Illnesses Modifiers

Here are diagnosis modifiers for all illnesses from the Off The Grid DLC.

illness can't be diagnosed by wards at all.

Revisit 15%10%10%10%10%10%10%9%10%10%10%10%10%10%15%10%10%10%10%10%11.15%7%7%7%10%10%15%10%7.5%10%10%10%10%10%10%60%8.75%8%8%8%18%15%9%60%8%8%8%18%18%18%15%11.70%5%5%5%5%5%3%10%12%12%12%12%12%9.9%15%15%15%15%7.5%60%7%18%18%18%18%13.2%70%17%24%7%17%17%17%9%60%28%10%10%10%10%10%8.4%15%15%15%15%15%9%12%12%12%12%10%10%10%5%10%12%7%12%12%12%5%12%7%12%12%12%5%100%75%12%7%12%12%12%5%15%15%15%15%8.75%60%7%18%18%18%18%13.2%70%12%7%12%12%12%5%15%15%-15%15%15%10%5%18%18%18%18%18%9%60%60%22%7%22%22%22%22%22%15%60%10%15%5%5%5%5%5%60%12%7%12%12%12%15%12%4.8%10%9%9%9%9%9%8%75%5%15%60%80%7%7%16%70%15%15%15%15%9%55%Revisit

You can use the "mega spreadsheet" below to interact with those modifiers. Just make a copy of the spreadsheet to be able to change the staff level and upgrades settings:

https://docs.google.com/spreadsheets/d/1TK9FKIUvC_bSgLTKgYwKA1DEE7HasQWpBd7s9IkdpDs/edit?usp=sharing

Culture Shock DLC Illnesses Modifiers

Here are diagnosis modifiers for all illnesses from the DLC.

Revisit 5%5%5%5%5%2.5%17%24%7%17%17%17%9%60%10%10%10%10%10%10%60%5%5%5%5%5%3%15%15%15%15%15%9%8%8%8%10%10%6%80%22%5%12%70%12%7%12%12%12%5%10%10%10%10%10%10%15%15%15%15%8.75%60%12%80%7%7%16%70%15%10%10%10%10%10%10%9%8%8%8%18%15%9%60%12%12%12%12%10%10%10%5%10%15%7%7%7%10%10%15%10%7.5%15%15%15%15%15%10%8%8%8%18%18%18%15%11.70%10%15%5%5%5%5%5%10%10%10%10%10%10%75%5%15%60%60%22%7%22%22%22%22%22%15%60%15%5%5%5%15%5%7.5%15%10%10%10%10%10%11.10%10%10%10%10%8.4%18%18%18%18%18%9%60%8.75%7%12%12%12%15%12%4.8%100%75%10%12%12%12%12%12%9.9%5%12%7%12%12%12%5%15%15%15%15%9%55%robe Malfunction60%7%18%18%18%18%13.2%70%15%15%15%15%7.5%Revisit

You can use the "mega spreadsheet" below to interact with those modifiers. Just make a copy of the spreadsheet to be able to change the staff level and upgrades settings:

https://docs.google.com/spreadsheets/d/1TK9FKIUvC_bSgLTKgYwKA1DEE7HasQWpBd7s9IkdpDs/edit?usp=sharing

A Stitch In Time DLC Illnesses Modifiers

Here are diagnosis modifiers for all illnesses from A Stitch in Time DLC.

The illness makes patients vomit a lot, without enough bins the hospital can quickly become very dirty.

, and can't be diagnosed by wards at all.

Revisit 12%12%12%12%10%90%15%15%15%15%15%15%15%15%9%80%15%5%10%10%10%50%17%7%17%17%17%17%9%60%8%15%8%18%8%9%60%90%15%15%15%15%15%15%15%15%9%80%15%15%-15%15%15%10%50%60%18%7%18%18%18%13.2%60%60%-12%60%7%18%15%7%15%15%15%11.50%15%15%15%15%8.75%55%15%15%15%15%15%15%11%70%10%10%10%10%10%10%50%50%15%15%15%15%15%15%9%50%10%10%10%10%8.4%50%12%7%12%12%12%5%7%12%12%12%15%12%4.8%15%15%15%15%8.75%5%5%5%5%5%3%90%15%15%15%15%15%15%15%15%9%80%60%15%15%15%6%60%8.75%12%7%12%12%12%5%60%12%50%50%5%8.75%15%10%10%10%10%10%11.18%-18%18%18%9%60%90%31.5%80%8%15%8%8%18%18%18%11.70%60%22%7%22%22%22%22%15%60%60%12%50%10%10%10%10%10%10%60%10%10%10%10%10%10%Revisit

You can use the "mega spreadsheet" below to interact with those modifiers. Just make a copy of the spreadsheet to be able to change the staff level and upgrades settings:

https://docs.google.com/spreadsheets/d/1TK9FKIUvC_bSgLTKgYwKA1DEE7HasQWpBd7s9IkdpDs/edit?usp=sharing

GP Dispatch Analysis

The following experiment took place at Lower Bullocks to see whether GP doctors dispatch patients randomly or to the best diagnosis room.

At the start of the experiment all patients were kicked from the hospital and all diagnosis rooms were built close to each other to see where new patients are dispatched by the GP doctors. All machines were level 1 and all rooms had a prestige level of 2.

Note that no room had a queue higher than 2 during the whole test except the ward that had sometimes.

1211121-11111---2-1----2-10---1-----2-1-11112222-19--2---11-1--2-8--111--1922-12911----10----1-101---2-19222211191

As we can see, it's probably not the best hospital for Lab since there aren't many "advanced" illnesses there. ^^ On the contrary, the ward is the most visited room.

Notice that there seems to be a correlation between the diagnosis rates and where the patients are dispatched. , , , , , and clearly show a preference for rooms where diagnosis rate tends to be higher even though it's not a hard rule. seems to be an exception (a bug ?) or maybe it's just that there isn't enough data.

It seems like there is an illness/room modifier when a GP dispatches patients that increases the chance to be sent to the appropriate diagnosis room. Note however that proximity seems to be a factor too. After the tests I moved the lab right next the GP offices and it seems like more patients visited it (mostly with "all around" illnesses like and ).

Here is a screenshot for those wondering what the layout of my diagnosis rooms looked like for the 2nd part of the test (the 2 GP Offices were in another building just below):

Note that those tests were done in a specific hospital with specific parameters. It's possible that there are more factors affecting the dispatch system like machine level, room prestige, queue size or other less obvious factors (and maybe even bugs). Also those results only show the first dispatch from a GP to a diagnosis room, maybe subsequent dispatches for difficult illnesses have their own priority rules.

By the way, be careful and don't just build all diagnosis rooms after seeing those results. Building a room and recruiting an employee raise the hospital level gauge. This can significantly increase the number of patients coming to your hospital and have a big impact on queues if you aren't ready.

Update (February 2020):

Many people claimed that a well trained GP doctor is much better at dispatching patients to the good rooms. So I checked to see if that's true and the short answer is that the qualification itself doesn't matter, it's the level of the doctor that "improves" the dispatching ability.

I tested the theory in a similar controlled experiment as above but I focused only on one illness this time. I chose because of the interesting modifiers it has. To diagnose it, Analysis and logy are much better than all other rooms with a 1% modifier. chiatry is good with a 20% mod but still inferior. All other rooms have a modifier of %.

First I checked with a level 1 doctor, the dispatch ratio matched the modifier ratio which again proved the fact that GP doctors don't randomly dispatch patients and base their choices on the modifier values. This low level doctor sent most patients to logy, Analysis but also a good amount to chiatry and from time to time but rarely to other rooms.

I switched the doctor with a level 2, then level , then and fully trained GP doctor and what's interesting is that the higher the level and the less they sent patients to chiatry room and other rooms with low modifiers. In the end, the level doctor was only sending them to the logy and Analysis which are by far the best rooms in this case and not once to other rooms.

Then I checked what changes the doctor behavior to confirm if it's the qualification, the diagnosis skill or the level. Ultimately, I found out that a level doctor with only research skills and 120% diagnosis skill was only choosing the best rooms contrary to a level 2 doctor with 2 GP skills and 120% diagnosis skill.

Conclusion:

GP doctors naturally send patients to the rooms with the highest modifiers more often. The higher level the doctors are and the more likely they will choose the rooms with the highest modifiers. Their qualification and diagnosis skill don't matter, only their level is important to improve their dispatch efficiency. However, diagnosis skill is still very important anyway so teaching them General Practice skills exclusively remains the best training choice in my opinion.

Chance To Die And Gauges Depletion

Here is another table with some data that aren't necessarily useful but still interesting I think. It includes the % chance to die when a treatment fails. For information, note also that for all illnesses in the game, the chance to show up as a ghost after death is 50%.

Regarding and numbers, it basically means that a patient with a multiplier higher than 1 will have the or gauge deplete faster.

For information, all other vital needs gauges deplete over time at the same speed for all base game illnesses except for "" and "". Patients with have their Toilets gauge deplete twice as fast as other patients. Patients with have their Hunger, Thirst and Boredom gauges deplete twice as fast as other patients.

An interesting thing to note is that all illnesses in psychiatry have no chance to kill a patient when the cure fails.

50%1125%0.75110%0.50.750%0.1120%1130%110%0.750.7530%11100%1140%11100%110%0.1150%11100%110%0.110%0.7510%0.50.550%1150%1130%1130%110%0.1110%110%0.10.75100%1110%0.751100%11100%0.75140%1120%110%0.1120%11.20%0.10.7510%1140%1.5110%110%0.1125%0.75150%1110%1120%1125%1140%1140%1130%1150%1150%1140%11100%1150%1120%0.750.75

Full Diagnosis During First GP Visit - Part 1

Since diagnosis bonus provided by multiple medicine cabinets stacks, many of us wondered whether it's possible to diagnose all illnesses at 100% with only a single visit of the General Practice office.

So take a look at the tables below to see how many cabinets are required to 100% diagnose an illness during the first GP visit. I wanted to have a table with all illnesses directly included there but it's too big for Steam. So I used a format similar to Mavocide's table that can be found there with interesting info:

https://www.reddit.com/r/TwoPointHospital/comments/9f623m/gp_diagnosis_formula_and_number_of_medicine/

GP modifiers and illnesses (for reference)

: Spontaneous Combustion, Touch of Midas, Anty Matter, Hyperrealty

: Gurning Loins, Jazz Hand, Jumbo DNA, Pudding Blood, Aurora Snorealis, Evergreen, Goobris, Buccanear, Jellied Feels, Placid Reflux, Shadow Boxer, Highly Ill-Suited, Isotrope, Warped

: Emperor Complex, Knightmares, Nerological Imbalance, Space Caged

: Cross Bones, Denim Genes, Flumps, Heart Throb, Leopard Skin, Shattered, Dead Arm, Half Pipe, Shin Blintz, Tartan Telomeres, Camel Toe, False Tan, Jet Leg, Lemon Soul, Limb Empathy, Gorm Deficiency, Grunt, Neutrainers, Platenary Ring, Star Struck, Telemutation

: Cubism, Premature Mummification, Monster Mishmash, Screwball, Lack of Humanity

: Lycanthropy, Pipe Organs, Turtle Head, Displaced Glands, Mechanical Metropolism, Reptilian Metropolism, Skull Chutney, Blank Look, Loose Jowels, Painapple, Wanderust, Bowhine, Extraterrestical, Flat-Packed, Frogborne, Hero Complex

: Boggled Mind, Mucky Feet, Anomalitis, Bard Flu, Football Crazy, Logic Problem, Deeply Ill-Suited, Horrorscope

: Decision Rash, Inflated Ego, Monobrow, Shock Horror, Bloaty Dread, Curdled Blood, Sore Judgement, Cauliflower Ears, Trumidity, Vested Insects, Aller-Gs, Zodiac Arrest

: Floppy Discs, Litter Bug, Mime Crisis, Spinal Bap, Blaggis, Cheese Bored, Paranoyance, Rantlers, Beach Wail, Brain Farts, Desserted, Wild Spore, Astroknot, Confidentures, Situational Gravity

50%: Broken Face, Grey Anatomy, Night Fever, Potty Mouth, Rock Bottom, Cold Shoulder, Inverted 1080, Thin Skinned, Budgie Struggler, Fool's Mould, Knobbly Knee, Cosmoss, Home Sick, Sputneck

55%: Freudian Lips, Brain Freeze

60%: Bogwarts, Hurty Leg, Jest Infection, Misery Guts, Boneless Thigs, Face Plant, Sweet Teeth, Heat Wave, Limpette, Tooth Mutiny, Continuthumb, Fanatick, Flack Hole

70%: Pandemic

75%: Portishead, Tongue Splinters, Hermitism, Science Friction

80%: Lazy Bones, Mood Poisoning, Barking Mad, Eye Candy, Crispy Skin, Oozmosis, Asterrhoids, H. G. Swells

85%: Bed Face

90%: Humerus Injury, Lightheadedness, Mock Start, Basic, Menace Elbow

100%: Verbal Diarrhoea, Sandy Crack, Meteormites

Buffs referenced in the table below are "Happy" and "Energised", they both add + diagnosis skill.

70% diagnosis skill132284861146940837430725621675%122778556443137434328023219580%114473052239834531525621117785%107168148636931929123519316190% (GP1 w/ 0 buff) 100663845334329526921617714695%948599424319275250200162133100%895564398298256232185149122105% (GP1 w/ 1 buff) 84853237428023921617113711118055043532622242021591271021 (GP1 w/ 2 buffs) 766477333247210189148117931 (GP2 w/ 0 buff) 73045331523219717713710885169643129821918516612899771 (GP2 w/ 1 buff) 6664112832071741561199271163839226919516414611185641 (GP2 w/ 2 buffs) 61137425618515413710478581 (GP3 w/ 0 buff) 587358244175146129977253150%564343232166137122906648155% (GP3 w/ 1 buff)542328221157130114846143160%522315211149123108785639165% (GP3 w/ 2 buffs)504303202142116102735135170% (GP4 w/ 0 buff)48629119313511096684731175%46928018512810490634327180% (GP4 w/ 1 buff)4532691771229885583923185%4382591691169380543520190% (GP4 w/ 2 buffs)4242501621108875503117195% (GP5 w/ 0 buff)4112411561058371462814200%398232149997866432511205% (GP5 w/ 1 buff)386224143957462392282374216137907058361962 (GP5 w/ 2 buffs)36320913286665533163

Full Diagnosis During First GP Visit - Part 2

diagnosis skill185159137104907868584316614212290776657483314912710878665647392513511396685747383118 (GP1 w/ 0 buff) 1221028558483931231195%1109175504031241759981664333251811-105% (GP1 w/ 1 buff) 907358362719126-110%81655130211471-115% (GP1 w/ 2 buffs) 745845241692--120% (GP2 w/ 0 buff) 66513919114---125%604533147----130% (GP2 w/ 1 buff) 544028103----135%4835236-----140% (GP2 w/ 2 buffs) 4330192-----145% (GP3 w/ 0 buff) 382515------1332111------1 (GP3 w/ 1 buff)29177------125144------165% (GP3 w/ 2 buffs)21101------1 (GP4 w/ 0 buff)187-------1144-------1 (GP4 w/ 1 buff)111-------18--------1 (GP4 w/ 2 buffs)5--------195% (GP5 w/ 0 buff)3--------200%---------

It's actually possible to build mega GP offices to diagnose all illnesses, for example with 386 medicine cabinets in hospitals with big buildings. It's expensive, requires a lot of efforts to place the cabinets and is kind of boring so it's not something I recommend at all. I did it for the sake of experimentation during the last mission with 4 huge GP offices + other big GP offices but I still also required more smaller GP offices because of the number of patients.

For science, here is how this kind of very ugly hospital can look like:

In any case, it's still a good idea to add some medicine cabinets when you have space in your diagnosis rooms since every little bit helps.

Best Diagnosis Rooms For Each Hospital

What's the best diagnosis room to use in this hospital ?

It's one of the most difficult question to answer because of many factors...

The diagnosis % of a room can be better than others at various stages of the game (early, mid or late game). For example, the ward is better than other rooms to diagnose some illnesses when their machine aren't upgraded yet but become worse after. Depending on the doctor/nurse's level and machine level, the range of illnesses that can be fully diagnosed with just a GP visit + any diagnosis room visit varies a lot too.

Moreover, some diagnosis rooms are much better to diagnose some difficult illnesses than others. Some rooms are faster, cheaper or more profitable, etc... Regarding missions, the illnesses show-up progressively. Actually, it's even possible to get 3 stars in a hospital without encountering all illnesses that can show up. Another factor is that the amount of patients isn't the same for all illnesses, some will be much more common than others.

That's why it's impossible to have a reliable ranking system per mission because it changes over time. Not all factors can be taken into account so my "ranking" below with only be based on these specific parameters:

- All staff members are specialized and at level 3 (look the "Staff specialization" chapter for more info)

- All machines are fully upgraded

- All illnesses showing up in the hospital will be taken into account no matter if they come early, late or less frequently

The ranking will be based on the extra amount of illnesses a room can fully diagnose compared to others or the highest diagnosis % than can be obtained for an illness.

You will see below that overall X-Ray seems to be the "best" diagnosis room.

The reason is that it has good illnesses modifiers and an advantage because the "Radiology" skill provides an extra +10% diagnosis skill to the doctor working there compared to most diagnosis rooms with a machine. It makes this room slightly better than others when they have the same base modifier. The fact that X-ray is also the fastest to diagnose a patient makes it a great room to build in any hospital. Just make sure the doctor working there has the "Radiology" skill for the bonus.

"Best" rooms are ranked from top to bottom. The number between parenthesis is the amount of illnesses for which a room is better than all other rooms (excluding of course illnesses that can already be fully diagnosed by all rooms).

1. Hogsport

Illnesses are easy to diagnose here so it doesn't really matter which room is used.

GD (1) = Cardio (1) = Psy (1) = Fluid (1) = X-Ray (1) = Mega (1) = DNA (1)

Ward (0)

2. Lower Bullocks

Fluid (3) = X-Ray (3)

Cardio (2) = Mega (2)

GD (1) = Psy (1) = DNA (1)

Ward (0)

3. Flottering

X-Ray (4)

Cardio (3)

Fluid (2)

GD (1) = Psy (1) = Mega (1) = DNA (1)

Ward (0)

4. Mitton University

Fluid (7)

Cardio (6) = X-Ray (6)

GD (4) = Mega (4) = DNA (4)

Psy (2)

Ward (0)

5. Tumble

X-Ray (5)

Cardio (4) = Fluid (4) = Mega (4)

GD (2) = Psy (2) = DNA (2)

Ward (1)

6. Flemington

X-Ray (11)

Fluid (8)

Cardio (6) = Mega (6)

GD (5)

DNA (3)

Psy (2)

Ward (0)

7. Smogley

X-Ray (10)

Fluid (7)

Mega (6)

Cardio (4)

GD (3) = DNA (3)

Psy (2)

Ward (1)

8. Melt Downs

Fluid (7)

Cardio (4) = X-Ray (4)

Mega (2) = DNA (2)

GD (1) = Ward (1)

Psy (0)

9. Duckworth-upon-Bilge

X-Ray (13)

Fluid (8)

Cardio (6)

GD (5) - Mega (5)

DNA (4)

Psy (2)

Ward (1)

10. Sweaty Palms

X-Ray (12)

Fluid (11)

Mega (10)

DNA (8)

GD (6)

Cardio (6)

Psy (2)

Ward (1)

11. Grockle Bay

X-Ray (13)

Fluid (10)

Mega (8)

DNA (7)

GD (5)

Cardio (5)

Ward (2)

Psy (2)

12. Blighton

X-Ray (12)

Fluid (11)

Cardio (7)

DNA (7)

GD (6)

Mega (5)

Psy (2)

Ward (1)

13. Rotting Hill

X-Ray (12)

Fluid (7) = Mega (7)

DNA (5)

Cardio (4)

GD (3)

Psy (2)

Ward (1)

14. Pelican Wharf

X-Ray (19)

Fluid (12)

Mega (11)

DNA (9)

GD (7) = Cardio (7)

Psy (2)

Ward (1)

15. Croquembouche

X-Ray (23)

Fluid (17)

Mega (13)

Cardio (11)

DNA (10)

GD (8)

Psy (4)

Ward (2)

Bigfoot DLC

16. Underlook Hotel

X-Ray (9)

Fluid (7)

Cardio (6)

Mega (5)

GD (4)

DNA (3)

Psy (1)

Ward (0)

17. Swelbard

X-Ray (15)

Fluid (14)

Cardio (10)

Mega (8)

GD (5) = DNA (5)

Psy (2)

Ward (0)

18. Roquefort Castle

X-Ray (18)

Fluid (13)

Mega (9)

Cardio (8)

GD (5) = DNA (5)

Psy (1)

Ward (0)

Pebberley Island DLC

19. Pebberley Reef

X-Ray (17)

Fluid (15)

Cardio (9)

Mega (8)

GD (6)

DNA (5)

Psy (2)

Ward (0)

20. Overgrowth

X-Ray (17)

Fluid (14)

Cardio (9) = Mega (9)

GD (8)

DNA (6)

Psy (3)

Ward (1)

21. Topless Mountain

X-Ray (21)

Fluid (16)

Cardio (12)

Mega (11)

GD (9)

DNA (7)

Psy (3)

Ward (1)

Close Encounters DLC

22. Goldpan

X-Ray (13)

Fluid (11)

Cardio (8)

GD (7)

Mega (6) = DNA (6)

Psy (2)

Ward (1)

23. Camouflage Falls

X-Ray (21)

Fluid (14)

Mega (12)

GD (9) = DNA (9)

Cardio (8)

Psy (2)

Ward (1)

24. Chasm 24

X-Ray (20)

Fluid (14)

Mega (13)

DNA (10)

GD (9)

Cardio (7)

Psy (2)

Ward (1)

Off The Grid DLC

25. Wanderoff

X-Ray (17)

Fluid (12)

Mega (9)

DNA (7)

GD (5) = Cardio (5)

Psy (2)

Ward (0)

26. Old Newpoint

X-Ray (20)

Fluid (14)

Mega (12)

GD (8) = DNA (8)

Cardio (7)

Psy (2)

Ward (1)

27. Windsock

X-Ray (21)

Mega (14)

Fluid (13)

DNA (10)

GD (9)

Cardio (6)

Psy (2)

Ward (1)

Culture Shock DLC

Plywood Studios

X-Ray (12)

Fluid (11)

Mega (6)

Cardio (5)

GD (4) = DNA (4)

Ward (1) = Psy (1)

Mudbury Festival

X-Ray (15)

Fluid (12)

Mega (10)

GD (8)

Cardio (7) = DNA (7)

Psy (2)

Ward (1)

Fitzpocket Academy

X-Ray (17)

Fluid (11) = Mega (11)

DNA (8)

GD (6)

Cardio (5)

Ward (1)

Psy (0)

A Stitch in Time DLC

Clockwise-upon-Thyme

X-Ray (6) = Mega (6)

GD (5) = Fluid (5)

Cardio (4) = DNA (4)

Psy (3)

Ward (1)

Clockwise-before-Thyme

X-Ray (11)

Fluid (10)

Mega (8)

Cardio (7)

GD (4) = DNA (4)

Psy (3)

Ward (1)

Clockwise-above-Thyme

X-Ray (17)

Mega (14)

Fluid (12)

Cardio (7) = DNA (7)

GD (4)

Ward (2) = Psy (2)

Conclusion:

With a specialized doctor having the "Radiology" skill, a fully upgraded X-Ray is the most reliable diagnosis room mid-game and allows to get a high diagnosis % for a big range of illnesses. Fluid Analysis is also great and works well in combination with the X-Ray. A third room I recommend is the Mega Scan which is overall well-rounded and better at diagnosing most difficult illnesses. Even though diagnosis rooms aren't really there to make money, the Mega Scan is also a good source of money.

Note that late game with level 5 employees, overall the Mega Scan tends to become better than other rooms followed by the X-Ray. The Fluid analysis room stays good but the DNA Lab becomes more reliable since it's better to diagnose some of the difficult illnesses.

That being said, it's important to remember that you can be very flexible with which diagnosis rooms you can build. It's possible to complete all missions with less than 3 different diagnosis rooms as long as staff is trained and machines upgraded. It's also possible to just progressively build all diagnosis rooms to complete all missions since higher level GP doctors tend to send patients to the best rooms anyway.

However, keep in mind that sometimes large queues can form up for one specific diagnosis room. That's why it's sometimes better to have for example 2 pairs of 2 different diagnosis rooms to share the queues more efficiently than 4 different diagnosis rooms.

Dear Hospital Administrators

This guide took a tremendous amount of time to research/experiment, to write and to double-check everything so I hope it will help some of you. ^^

If you spot any issue, do not hesitate to let me know in the comments below.

Thanks for reading.

Yours fragrantly,

Freiya

Source: https://steamcommunity.com/sharedfiles/filedetails/?id=1519429114					

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