This is a system I just literally thought up right this second so forgive me if it has holes, as it most likely will, but it's something that could easily be refined with some discussion here.
Hit points are done away with, entirely.
Instead, you have 'hits'.
Minions can take one 'hit'.
Standard monsters can take two 'hits'.
Elites can take four hits.
And solos can take six hits.
PC's can generally take four hits as a base (plus one per tier, thus 5 at 1st-level) however Toughness can increase this by one hit per tier and each tier brings a bonus hit. Toughness now has three levels, one applying to each tier and each feat being a prerequisite for the next higher tier feat.
There is no longer any such thing as 'damage on a miss'. You either hit or you miss. Yes, this will break many feats... too bad. Don't like it, don't use a system looking to be grittier and more deadly
Healing surges now cure 'hits'. Instead of curing more damage, a healer's bonus healing such as that from Healer's Lore, simply cures an extra hit. Elite's have one healing surge they can spend in a combat, and solos have two.
Critical hits deal two 'hits' worth of damage.
Any monster or character that has been hit, is considered 'bloodied'.
Also, a coup de grace can outright kill any character or monster if it hits, regardless of how many more 'hits' the monster or character can take. In addition, the circumstances for coup de grace are widened. Someone with a crossbow stuck up against your skull would qualify for a coup de grace if they hit, same as if someone has one pointed at your chest and is a marksman. Doesn't matter what level you are, a crossbow bolt through your skull or heart is going to kill you.
When a monster reaches 0 hits, they're dead. When a PC reaches 0 hits, they make Survival Checks. A Survival Check is a Death Save modified by your Constitution modifier.
Whattya think?
Hit points are done away with, entirely.
Instead, you have 'hits'.
Minions can take one 'hit'.
Standard monsters can take two 'hits'.
Elites can take four hits.
And solos can take six hits.
PC's can generally take four hits as a base (plus one per tier, thus 5 at 1st-level) however Toughness can increase this by one hit per tier and each tier brings a bonus hit. Toughness now has three levels, one applying to each tier and each feat being a prerequisite for the next higher tier feat.
There is no longer any such thing as 'damage on a miss'. You either hit or you miss. Yes, this will break many feats... too bad. Don't like it, don't use a system looking to be grittier and more deadly

Healing surges now cure 'hits'. Instead of curing more damage, a healer's bonus healing such as that from Healer's Lore, simply cures an extra hit. Elite's have one healing surge they can spend in a combat, and solos have two.
Critical hits deal two 'hits' worth of damage.
Any monster or character that has been hit, is considered 'bloodied'.
Also, a coup de grace can outright kill any character or monster if it hits, regardless of how many more 'hits' the monster or character can take. In addition, the circumstances for coup de grace are widened. Someone with a crossbow stuck up against your skull would qualify for a coup de grace if they hit, same as if someone has one pointed at your chest and is a marksman. Doesn't matter what level you are, a crossbow bolt through your skull or heart is going to kill you.
When a monster reaches 0 hits, they're dead. When a PC reaches 0 hits, they make Survival Checks. A Survival Check is a Death Save modified by your Constitution modifier.
Whattya think?