I’ll be DMing some more 5e soon and I want to take the opportunity to try some different ways of playing (I’ll post my own suggestions as comments so they can start their own discussion threads). What alternate rules have you tried that you thought worked well? They can be larger changes to the game or little QoL tweaks (though if you can respond to the suggestion with “at this point just play [different game] instead” then that’s probably more than what I’m looking for!)
As PC’s progress, falling to 0HP in combat gets less and less meaningful. So I have used a rule that whenever a PC is at 0HP at the end of their turn, OR fail a death save, they take a level of exhaustion. It makes the 0HP yo-yo more dangerous, and makes it so “death” has some longer term consequences.
I tried this for a bit and everyone hated it. We were only like 6th level though.
A variant I considered but didn’t try was to track how far into the negative you go. So if you get slammed by a dragon for 40 damage and you had 10/60 HP, now you’re at -30. A basic healing word isn’t going to wake you up.
My group uses this, but with a separate temporary exhaustion (we call it Trauma) that goes away on a short rest. Still handily serves the purpose of discouraging yoyoing without being too punitive.
Does this end up overly punishing for the tank and largely irrelevant for the ranged attackers? Exhaustion can take a while to get rid of so I wouldn’t want to be too harsh on the front-liners just for doing their job!