Project Hospital Review

Project Hospital is the latest in the recent flurry of hospital themed games and sims, going hard on the sim part, and easy on the Nitrous-Oxide.

Project Hospital was played primarily on a Mac, and a review key was kindly provided by Oxymoron Games.


Everybody has Gluten Allergy

It’s easy to just think of Project Hospital as similar to 1997s Theme Hospital, but where various medical sims and games tend to either hide the medicine stuff behind euphemisms and jokes, or just focus hard on the logistical and business management, Project Hospital goes almost all-in on the medical side as well as the logistics. Symptoms are presented for each patient, and a list of real-world diagnoses is whittled down until 1 remain, and while the staff can usually handle this, sometimes you’re asked to give a consult.

The range of conditions that you face early on is pretty narrow but grows as your hospital does. Initially it’s mostly bruises, contusions, and fractures, forcing you to build an x-ray room, and set up a Radiology department. This seems to be done to make things more manageable, but when suddenly half your patients all have Coeliac Disease, you kind of wish there was a bit more variety. Of course, this could just be our imaginary hospital is located in California.


An odd one is when you’re asked to consult on a bruise, and the options are to x-ray 3 very different parts of the patient’s body. Perhaps the location of the bruise could be an indicator for what part to look at, but not really seeing that anywhere.


There’s also a nice’ish option that you can simply guess and give a patient a treatment, hoping it’s the right one. This aspect to some degree mimics how medicine is at least partly about statistics and what diagnosis is most likely, and it’s made easier by the fact that some conditions have the same treatment making it less critical that you selected the right one.



When building your new hospital, you get to choose whether to put in every part yourself or use a set of pre-built “fabs” for rooms. These are all very elaborately designed, with all the doodads and gizmos, and excellent for helping you make a nice hospital. The counterpoint is that they are sort-of large and might not fit perfectly where you want them, and so you’ll have to make modifications or just build your own rooms.


One thing that’s been puzzling me is that the pre-fab for the MRI room costs 35K, while the MRI machine alone costs 45K. This might be a bug, but one I’ll accept since the MRI room is pretty handy at times.


Solve One Thing, On To The Next!

The game does a good job of progressing you from stage-to-stage as your hospital grows and you unlock new departments. Once one department is running somewhat smoothly you’ll have the next one available and likely a recent influx of money to help build it. ICU, Trauma, Surgery, Internal Medicine etc unlock at a steady pace, and with them an insurance company that brings in more patients and new goals.

Of course, there’s nothing to keep you from starting to build stuff a bit early and wasting your money, such as filling out all functions of your Radiology department before you really need those last bits.


When you get more departments, you may find that you need to shift patients around a bit, perhaps send a Surgery patient to the ICU or Trauma Center for treatment due to limited space. You might also find that there are cases where it’s just safer to bump them to another hospital altogether, but then you also earn less.


Marvels of Modern Socialism?

Coming from a modern country with a good healthcare system, playing a game where you run a for-profit hospital, with patients categorized by whether they have private insurance, and money being king, feels a bit jarring. Sure, we have private hospitals, especially for elective surgeries, but basic medicine being a for-pay service makes the game experience an alien one, at least for me. It’s not as clear an indictment of the concept as Prison Architect is against for-profit incarceration, but it can’t help reflect the flaws of the system.


NSAIDs Everywhere!

Playing the game, doling out diagnoses and medicines, I’m constantly concerned that the drugs might have adverse interactions, or actually be contraindicated for a situation. So far there’s not been any complaints from the game or the virtual patients, but definitely had a few situations where I was certain that what I was doing was wrong. You can also start treatments with analgesics and NSAIDs early, even if that could suppress undiscovered symptoms, and again there’s nothing in the game that says whether this will be an actual problem.


Do You Have Problem?

The biggest issue with the game, though, is quality-of-life things. Issues like the game insisting on pausing when you switch to another program (it’s a Sim, of course we’re browsing and chatting in parallel!) or when you switch to management-mode, is just frustrating because the game is pretty independent as-is. Once a department is running, you’ll want to leave the game a bit until there’s an issue that requires your attention.

Other bits, like extending areas is also in need of touch-ups, though at least you can place one area inside another one (reception inside waiting rooms).


Picking up and moving things is awkward, there no feedback on whether there’s benefit a to place an item in a room, and no reason for using the more expensive equipment, all makes the architectural part of the game feel meaningless and frustrating.


Path-finding seems a mess at times. At one point I had patients walk in a big circle around a room to use the door on the other side, instead of the one leading into the waiting area, and sometimes you’ll see nurses go grab a different stretcher than you’d expect.


Doctors also have a tendency to give up too quickly, requesting your help on very basic things. The fix to this, of course, is to hire better doctors.


Patients can get stuck, holding up a doctor until some event, or sleeping in the X-Ray machine for no apparent reason. Nurses can refuse for days to transfer patients to Radiology, resulting in a huge backlog, and I’ve seen a tech just not leaving his seat, even to go home. All of which looks like more testing is in order, and I hope the developers are getting some save-files from players to try out and see how the game behaves in different setups.


Final Thoughts

It’s a good sim, less laugh-out-loud fun than others but decently demanding, and the choice of using semi-realistic treatments gives it a good feel, and might even make for a good educational tool with a younger audience.

Just keep it away from medical students and hypochondriacs.




Design:  7

Visually the game is simple and clean, but perhaps not the most modern and with room for improvement. The music and sounds are nice and simple, befitting the game’s setting, and foregoing the gauche option of patients wailing and crying out in pain.

The Mechanical design is very functional but comes up short in the quality-of-life department, and definitely needs a once-over by the team.


Challenge:  7

New Player introduction is done nicely, with basic scenarios, but quickly becomes too much with too-complex buildings to manage. Some of this could do with a slight re-visiting. For the casual player, it’s likely straight to the sandbox though, and here the progression of difficulty and challenges flow well.


Fun:  6

As mentioned, the game isn’t laugh-out-loud funny, it’s not trying to be a joke. It is, however, well entertaining for the sim-lovers and people with medical bone, but at the same time it will likely scare away the most-casual of players.


Longevity:  5

If the game bites you just right, this is one you’ll be playing for a while, or revisiting at intervals, except for the fact that playing it in long sessions just isn’t feasible with the constant auto-pausing. Give players an option to keep it running when not in-focus, and to let the game progress at slowest pace when in Management mode will help a lot here.


Price:  7

The game runs for €25 on Steam, which feels adequate for what you get. More polishing, perhaps mod-support to keep it running longer, and fixing of glitches are definitely needed, and if you’re on the fence consider wish-listing it for now as the developers look to be fixing things and any discount will definitely make it worth getting.


Overall Score: 6.4 out of 10 – Not Quite In Vein