If a Skinwalker gets inside, stop admitting patients, identify where it is, use a safe tool such as Gun or Taser when available, and recover before reopening the Shutter. A Skinwalker means the front decision already failed or an anomaly slipped through. Treat it as a run emergency, not background combat.
A Skinwalker inside the hospital means the run has already made one serious mistake. Stop adding patients, call where it is, and use distance or a safe tool when you have one. The front should stay closed until the threat is handled.
In actual runs, I keep the order short enough to remember while alarms and room prompts are going off: Close the Shutter. Call the Skinwalker location. Use the safest available tool or distance. Recover Sanity and room status before admitting again. That order keeps the desk from drifting open while someone is still fixing a room or recovering Sanity. It also gives public lobbies a simple rhythm: one player says the job, one player handles it, and nobody adds a fresh patient until the current problem is under control.
The panic move is everyone chasing the Skinwalker through the halls while the desk opens again. That turns one hostile enemy into a second wrong admit or an abandoned patient.
The habits that save the run are small but noticeable. Do not fight while the Shutter is open. Let one responder handle it when possible. Stop new admits until someone owns the current decision. Animal Hospital becomes harder when the desk opens a patient while another threat is still unresolved. Most failures come from stacking problems: a rushed Shutter open, an unfinished treatment room, and a Sanity drop happening at the same time. When another player already has the problem covered, the best help is often boring: hold the Shutter, watch the next patient, or finish the room that got interrupted. Crowding the same spot usually hides the next mistake instead of fixing the current one.
For quick lobby decisions, the answers stay simple. Should everyone respond at once? No. Send one responder when possible and keep the Shutter covered. What should solo players do first? Secure the Shutter, solve the active problem, then return to treatment or recovery. If the lobby feels messy, name the active problem out loud: unchecked patient, unfinished treatment, low Sanity, enemy, fire, ambulance, or ritual. Once the group knows which one is active, the next move is much easier to choose.
After the danger clears, I like taking one short reset before speeding up again. Check Sanity, check the room that got interrupted, and check whether the next animal outside has been fully screened. That tiny pause feels slow, but it stops one mistake from turning into three.