Tier competitions allow you to take part in a mini tournament on your own.
There are 5 waves of 100 patients that come to your hospital pretty much all at the same time. You have limited time to cure as many of them as posible and the time you get to do that is shortened with 2 minutes every wave. So while you have 20 minutes in wave 1, you only have 12 minutes in wave 5.
The cure points that every patient need increases every wave aswell. So while a patient may need 500 cure points in wave 1 that can be 1000 or more in wave 5. I do not know the exact math needed to predict the cure points that the patients will need. Note that patients that normally stand out a bit for being more dificult to cure (like zonbies, cat slaves and obesity for example) will be harder to cure than other patients in this competition aswell.
Each Patients has own unique percentage increase that can be worked out from what patients require in normal game play vs what they require in wave 1.
Example Pheumonia patients requires 1500 points in normal play, but 1785 in Wave 1. this is an increase of 19%. Each wave increase by 19% from the last wave.
Pheumonia 19% increase
Normal Play 1500
Wave 1 1785
Wave 2 2124
Wave 3 2527
Wave 4 3008
Wave 5 3579
Each patient you cure awards you points and the number of points you receive for each cured patient is increased by 1 every wave. So in wave 1 you get 10 points per patient and in wave 5 you get 14 points per patient you cure.Your best score from each wave is added together to make your overall score.
As you take part in the waves, your score will add up and you will be ranked for it.
At the end of the competition, your ranking determines your tier, the higher the tier, the better the reward.
Taking part in this Tier competition will not effect your hospital. The patients give no xp, do not pay you money but also do not effect your cure% or hospital rating when they get send home, die or are not cured. Because of this it is safe to send patients home that are too hard to cure or cause you too much trouble. Specially when you have a lower level hospital it can be usefull to send home some patients that are too dificult or that can kill other patients so that the ones that stay at your hospital get processed faster so they will not get angry and walk out on you.
At higher level getting a few massage stools will help you a great deal to keep these huge waves of patients happy. Massage stools are far more effective than pictorials because patients will use them sooner (at around 35% happynes) and they give more happyness points to your patients. 30 instead of the 10 a pictorial gives.
I will add hints and tips when i am familiar with this concept of the game.
One thing so far id say is to make sure you have a few receptionists and desks to accomodate the 100 patients which all run into your hospital in a line when you begin a wave.
Feel free to share your own insight if you have experience.