Review: Healthy Heart Hospital

Healthy Heart Hospital. Victory Point Games, 2015. Game designers: Scott and Anna-Marie Nelson. Game developer: Nathan Hansen. USD $49.99.

Most of the games we look at here at PAXsims are wargames or conflict simulations, of which there are a great many–indeed, far more than we can possibly review. Games that explore organizational processes and institutional change are much rarer, however. Yet such games can be of particular interest to those dealing with issues of peacebuilding, capacity-building, inter-agency cooperation, development aid, and humanitarian assistance. There is, after all, a reason why we made attending meetings such a significant part of our own AFTERSHOCK humanitarian game design. I’ll admit too that I have always liked medically-themed games—Pandemic is an all-time favourite, and I co-designed Zombiton NHS, a game about Zombies in a UK children’s hospital.

Healthy Heart Hospital is a cooperative game for 1-5 players that makes management and capacity-building issues central to game play. The game is designed for hobby play, and is not intended as simulation of contemporary American hospital management (despite quite a bit of implicit tongue-in-cheek commentary on for-profit medical care). However, several of the game mechanics could be easily adapted for more serious games on this and other topics. A game play takes 60-90 minutes.

Image: Scott Nelson/BGG.

In the game, players are tasked with reviving the reputation and financial fortunes of Healthy Heart Hospital. To do so, they’ll need to assign staff actions to process and treat the patients arriving each turn in the waiting room. Healing patients generates revenue, while curing and discharging them raises the prestige of the hospital. Conversely, if patients die there is a financial and prestige cost.

The hospital’s  doctors and the senior administrator all have special abilities, such as medical specializations, research expertise, or discounts on other actions. For example, Doctor Lucky—the staff pathologist—can hide a body to lessen the financial cost of death settlements. As the prestige of the hospital improves players can also hire more junior staff, such as technicians and nurses to improve the performance of wards, a human resource manager to reduce the cost of new hires, a lawyer to reduce the financial cost of malpractice, or a public relations specialist to reduce the prestige cost of patient deaths. The chaplain can even try to bring about miraculous cures.

In addition to investing in new staff, players can also invest in improved training, as well as expansions to the hospital itself. The latter might include an emergency room (handy for reducing patients deaths in the waiting room), operating rooms (which provide higher-quality care and increased revenue and prestige), a research lab, a morgue (for hiding even more bodies), a clinic for patients with minor ailments, and even a staff break room.

The rules (downloadable here, via BGG) are clear and game play is straight forward. My only real quibble was that the headline text on the Ambulance Cards (which are used to generate new patients each turn) has nothing to do with game effects. It might have made sense, for example, for a card to indicate an accident and generate largely trauma patients, or for an epidemic to primarily generate new patients for the infectious disease ward. However, overall I found Healthy Heart Hospital to be a very enjoyable challenge, even as a solo game.

As noted earlier, there’s also much here—from workload and personnel management to strategic investment in staff training and physical infrastructure—that could be adapted or built upon for serious game designs. Although not intended for teaching purposes, it could be used in classroom setting for courses on health policy, public or private sector management, or public policy, with students asked to review the game or suggest game modifications that more closely model actual health care delivery challenges. While the rules are straight-forward, it might be best to play a partial game in class to teach the rules and then have students play in their own time as a course assignment.