The presenting complaint, its acuity, the working diagnosis, the bloods it calls for, the procedure if it needs theatre, the expected stay, and the tasks that make the care safe. Now and then, an incident with several casualties at once.
Simulator · not published, available on request
A hospital you can run before you build it
Meridian General is not a real hospital. It is a working one: a composite built in a game engine, sized against two real hospitals, one in London and one in Lagos, so that every corridor, ward, lift and queue behaves like the thing it stands for. It exists so that a decision that will stand for sixty years can be run against realistic demand first, and shown to hold, before anyone signs it.
The Meridian case study records the one rule that makes the rest of it honest: nothing irreversible is committed until it has been run. A parcel, a massing, a department mix, an operating policy: each is a decision that will stand for sixty years and is usually signed on a drawing and a spreadsheet. The simulator is where it is run instead.
It is a complete hospital. Patients arrive on a curve that peaks late morning and again mid evening, are triaged, are sent home, to urgent care, to majors or to a ward, deteriorate, go to theatre, and leave one of six ways. Rostered people do the work, and only they can. The power goes. Inspections come. Lifts queue. The day runs at any pace from a second to real time, and tied to the calendar it fills two years of its own history before you walk in.
2real hospitals it is calibrated against, one in London, one in Lagos
1 to 86,400seconds per simulated day: a day in a second, or real time
6ways an admission can end, and only one is the one everybody plans for
0tasks completed by nobody: every piece of care is done by a rostered person or stepped over, once, out loud
Chapter 1 · Engines, not settings
What it runs on
The hospital is data read at start up from a shelf of books, each written by its own engine. Change a book and the whole hospital feels it in the next slice of the day. Nothing in the building is hard coded.
Every piece of care is a task in a catalogue: who may do it, how many hands, how long, when it is due, and its steps. A task invented on the catalogue's own web page reaches the hospital without a line of code. Each patient has one care plan, one list, including what they asked for themselves.
One knob per number, in a rule set called as built. Where the catalogue and the rules both speak, the rule wins. Turn a knob and the whole hospital feels it.
One standard per governed thing, however many jurisdictions set a value for it, each carrying its confidence and who checked it. A value is null until it is ruled, and a reader must refuse an unruled standard rather than default it.
Buildings, entrances, zones and a routing graph. Roles and what each may open. Ward types and ward lists, the equipment, the day care services, the gazetteer with its jurisdictions, the legal register, and the rates that price every square metre as you watch.
What one person here may say to another. Every line a permission, never an instruction, so the hospital's people act on their roster and their capability, not on a script.
Chapter 2 · The bad night, on purpose
What it is tested by
A hospital that models only tidy discharges is not modelling a hospital. The simulator carries the things a clinical business case assumes are simply there, and takes them away on schedule.
Downtime cascades from a failed system to a closed ward. Inspections arrive with a findings register and a compliance score that follows you. The referral to treatment clock runs with a pause audit trail. Lifts queue. Shifts hand over with latency. A bed is not free until it has been turned round. And any patient can deteriorate, which is the moment the hospital is really tested.
Chapter 3 · Shadow, do not run
How you use it
You do not run the hospital. You shadow it. Stand beside a rostered person and follow them as the hospital gives them their work; nothing is taken over. The one thing you may do yourself is escort a transfer: a porter, a nurse, the journey's own minutes, and the patient reaches the bed when it is complete.
That is deliberate. The simulator is an instrument for seeing what a design does to the people inside it, not a game about managing them. Layouts are drawn by the Don and by the Advisor from templates for majors, resus, urgent care and ward towers, and each one is run before it is kept.
Chapter 4 · Plainly
What state it is in
A working build exists for Windows and for Android. It is calibrated for size against its two reference hospitals; the clinical figures inside it carry their basis, sourced, derived or placeholder, in the same way every figure on this site does. It is in daily use on the Meridian study and it is not polished for strangers.
It is not published. If you have a hospital question of the kind it answers, where to build, how many beds, what a ward costs when the grid goes, what a roster does on a Tuesday night, ask. It can be run on your question, or made available to you, and the first conversation costs nothing.
It is not published, but it exists.
Say what you would run in it, and I reply within one working day.
Ask about Meridian General