Items are cool; but they don't get you as far in the map as you'd hope, especially since the only way to get through some doors is using keycards, something locked behind repetitive streaks of genocidal staff murder. You're not always gonna have a giant-ass group of patients ready to rush the guards (even if you do, most of the times the guards will just hide behind the doors that the patients don't have access to, call reinforcements and swipe the whole team down)
I'd love if the asylum escape method also had "stealth" based options in the sense that most of the times you're just trying to act uninvolved with whatever the rest of the staff / patients are up to (basically just trying to stay out of sight) Something like this would probably take much slower, to reward face-to-face combat.
The game is fine (sort of.. well, it's definitely subjective) as it is right now, I just find this a concept that I'd wish the developers to consider one day.