Dice Hospital

30th December 2021

Thursday afternoon gaming on Board Game Arena continued with Dice Hospital.

Doctor, doctor, please
Oh, the mess I'm in
Doctor, doctor, please
Oh, the mess I'm in

Mismanaging your hospital in Dice Hospital will definitely lead to a big mess!

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What's in a game?

• Player board: Dice Hospital's player boards are curiously hexagonally shaped and each contains a number of hexes which represent different departments
  Coloured hexes: There are 3 hexes which are red, yellow and green, they represent critical care, oncology and pharmacy.
  Numbered hexes: There are 3 hexes numbered 1-2, 3-4 and 5-6, they are intensive care, imaging and clinic.
  Wards: There are 4 ward hexes and each has room for 3 patients (dice.), thus 12 patients in total. Each hex also has spaces to place 'treated' patients.
  Nurse's station: This hex is where general nurses are placed at the start of each round.
  Discharge: This is where patients go when things go well.
  Mortuary: And this where patients go when things go bad!
• Department tiles: Players can expand their hospitals by acquiring these hexagonal tiles. Departments improve a hospital's abilities to heal patients. Departments may be colour-specific (Red, yellow or green.) or 'neutral' (Blue.) which is generally number based.
• Specialist cards: Players may also recruit extra workers into their hospitals in the form of specialist and these cards list their specialities. Like departments, specialists may be colour-specific or neutral.
• Administrator cards: Each player will get one of these and they confer some unique benefit or scoring bonus to the owning player.
• Meeples: These nurse shaped meeples (Neeples?) come in 5 colours, white and blue, as well as red, yellow and green which relate to the identically coloured departments. The white and blue are essentially general staff.
• Dice: You won't be surprised to learn that Dice Hospital uses six-sided dice, a lot of them. They are used to represent patients and come in red, yellow and green which indicate the type of treatment they need; critical care, oncology or pharmacy. There are 21 in each colour and 63 in total.
• Bag: Goes with the dice.
• Ambulance tiles: There are 5 of these and they're numbered as such. Ambulances are used to deliver patients to hospitals, each ambulance has room for 3 dice.
  NOTE: The ambulance models seen in the photos here DO NOT come with the base game.
• Blood bag tokens: Provide players with some special actions when used or VPs at the game end.
• Fatality tokens: I'm sure get the idea...

There are some other tokens, but they're not significant to gameplay.

The component quality in Dice Hospital is all round good. The tiles are study and cards are of the expected quality. The game's 60 or so dice are plastic but with well rounded corners and satisfying to roll. Finally, all the meeples are stylised after medical staff, it's a nice touch and appreciated, they're made of wood too! Good stuff.

All of the art for the different departments on the hex tiles is quite small but also well detailed and depicts a variety of different medical equipment and hospital furniture, I quite like it.
The specialist cards have headshots of doctors, it's sort of average artwork but on the hand, they look like medical staff, what more could you want? Besides, how much more exciting could you make the portrait of a urologist look!

We found the game's iconography initially a little confusing but after a couple of references to the rulebook, it was always sorted out.
​None if it's a dealbreaker.

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How's it play?
Setup

• Dice: Put the allotted number of dice into the dice bag and give it a good shake.
• Department tiles: Shuffle the tiles into a face-down stack and deal the allotted amount face-up, (This'll be equal to 1 less than the number of players.).
• Specialist cards: The same as the department tiles:
• Ambulance tiles: Use a number of tiles equal to 1 higher than the number of players. Start with the number 1 ambulance and put them out in sequential order.
• Player board: Give each player a board and 3 white meeples, the meeples should go into the nurse's station
• Administrator: Shuffle the administrator card and deal 2 face-down to each player. Players should which one to keep and discard the other out of the game.
• Patients: Each player should draw 3 dice blindly from the bag and set the faces to 3, 4 and 5 how they see fit, then place them into 3 spaces on one of their ward hexes.
• First player: Determine the 1st player.

That's pretty much it for set up. You'll notice that there's always never quite enough departments and specialists for players to take all of one or the other. Additionally, there's always enough ambulances to give every player a choice between at least 2.

On to play
​Dice Hospital is played over 6 phases, some of these phases are completed in turn order and some can be completed simultaneously.

• Patients: The 1st player blindly draws a number of dice equal to the number of dice spaces on all the available ambulance tiles.
  The 1st player then rolls all these dice, any 1s or 6s are rerolled until all dice are showing 2-5.
  The dice are then placed on to the ambulance tiles, placing the lowest numbered dice on to the lowest numbered ambulance and go upwards so that the highest numbered dice end up on the highest numbered ambulance tile. The player to the right of the 1st player (The last player essentially.) may then have the opportunity to rearrange some of them.
  After this and in turn order, each player takes an ambulance tile and adds the dice to their wards. The only restriction here is that the 1st player cannot take the 1 ambulance, which prevents them constantly going first.
  If there's no space for new patients on the wards, then some patients will need to be sent to the morgue!
  ​Finally, a new turn order based specifically on the ambulance numbers is established and a new 1st player is determined, this player also gains a blood bag token.
• Improvements: In this phase, players draft improvements into their hospital and this is where the new turn order becomes significant. In this new turn order, each player takes either a department hex or a specialist card (And appropriate meeple.) and adds it to their player board or play area.
  Furthermore; each player may discard exactly 1 improvement to gain a blood bag.
• Hospital phase: This where arguably, the bulk of the game takes place, this can be played in order or simultaneously.
  Here players take their meeples and puts them into departments to heal patients. how is this done?
  If a meeple is put into the green hex for example, then a green die may be healed. Healing does 2 things, it increases a die's value by 1 (E.G., from 3 to 4.) and moves it to a 'treated' space in the ward. A die may be healed multiple times from multiple sources and if it's value would be taken to 7+, it is then sent to the discharge hex. More on discharging below.
  Improved departments generally allow more than 1 patient to be healed, althohg some allow lesser number of patients to be healed by more.
  There can be restrictions however.
  For example a red department may allow 3 red dice of equal value to be healed by 1 each, but it would have to exactly 3 not less. A neutral department may allow 2 dice with values of 1-3 to be healed regardless of colour.
  Specialists also provide more healing but may be limited. A yellow specialist used to heal a yellow die may also heal a 2nd yellow die.
  The abilities of departments and specialists may be combined. If a green specialist is placed on a neutral department and one of the dice healed is green, then the green specialist's ability would be activated.
  Each department and meeple can only be used once per round.
  Blood bags: These tokens can be spent for 2 effects, firstly, any die can be healed by 1 point, secondly, the colour of a die can changed to either of the 2 other colours. This is pretty useful when used with consideration, especially if activates a a department that could not be otherwise activated.
• Neglect: Now we get to the bad part!
  Any die that were not treated, i.e. not moved to a treated space, has its value lowered by 1. If this would take a die's value down to 0, then that patient dies and the die (sic) is sent to the morgue.
  Every die sent to the morgue by a player earns them a fatality token. Then that die is returned to the bag.
• Discharge patients: During this phase all patients are discharged and score VPs for the player. The discharged dice are returned to the bag.
  Scoring in Dice Hospital is a little unusual and exponentially increases if more patients are discharged at the same time.
  What this means is if 1 patient is discharged, then 1 VP is earned. If 2 patients are discharged at the same time, 3 VPS are earned and so on. If a player manages to discharge all 12 patients at the same time, they'd earn 35 VPs.!
  ​Additionally, if a player's wards are all empty during this phase, they earn a bonus 5 VPs.
• End of round: This is the final phase of the round.
  Players' return all their meeples to their starting spots.
  All patients who were treated are moved back to their untreated spots.
  Any departments or specialists who were not drafted during the improvement phase are discarded to the bottom of their relevant stacks and new departments and specialists are drawn in preparation for the following round.

Play now progresses to the next round, with the 1st player drawing and rolling dice and the dice drafting phase and so on.

Endgame
Play continues until 8 rounds have been completed. Upon reaching the end, players calculate their final scores, this includes:
VPs for discharging patients over the 8 rounds.
+1 per unspent blood bag.
-2 per fatality token acquired. 
Scores are tallied, highest score wins.

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Overall
As well as randomly determining which improvements appear, I like how the game makes use of dice as both a randomiser and a resource to be managed. Using dice value to gauge health levels and colours to represent different types of malady is innovative and great.

There's a lot of good gameplay in Dice Hospital and a lot to like. Figuring out how to strike balance the hospital's different needs, requirements and aspects is a satisfying challenge.

In this regard, the game's 2-tier drafting mechanics work well, drafting patients that are easier to heal means going later when drafting hospital improvements, that's a good balancing mechanic with meaningful decisions. There's also a higher level of play at work here, if you can anticipate which patients/improvements other players are looking to acquire, you can either try and either deny them what they want or make it easier to get what you want. For example, if no one else wants a red doctor, then going last in the improvement drafting phase is not a problem.

Knowing what and when to draft is probably the single most important aspect of the game, using those combinations of special abilities to heal multiple patients at a time is vital. It's also contextual, depending on the colour of patients and improvements appear and what a player already has in their hospital. Players may find themselves having to reappraise their strategy from turn to turn. Willingness to trash an improvement for a blood bag can also be a powerful play, used right, blood bags can provide much more than a single VP.
Luckily, the game provides fairly good opportunities to combo departments and specialists off each other, especially toward the latter half.
However, getting that balance wrong leads to sub-optimal play, having to many departments leaves them unused and too many specialists means they just do nothing.

Even though it's an abstract dice game, it genuinely feels a bit like you're running a hospital, having to try and find ways to treat and discharge patients before the next influx of unending patient.
This is not a coincidence. Players start the game with 3 patients and acquire 3 more every round, this means by the end of the 3rd round, they'll have filled all their wards (Provided they haven't already discharged any patients.), as a consequence, players will need to discharge 3 patients a round just to avoid sending some to the morgue.
Thanks to the scoring though, there's a wrinkle here. Discharging patients in drips and drabs doesn't score many VPs. Players will actually want their patient numbers to build up a bit and discharge as many of them at once as possible to optimise scoring.
It's a another balancing act and it all combines to make Dice Hospital a good game.

If you like worker placement mechanics, blended with a bit mid-complexity, light randomness, meaningful choices and almost engine building elements; then Dice Hospital is worth a try. One I found an enjoyable experience.