Pata

11-116

January 3, 2012

Massachusetts General Hospital's Pre-Admission Testing

Area (PATA)1

Kelsey McCarty, Jérémie Gallien, Retsef Levi

Located in Boston, Massachusetts, the Massachusetts General Hospital (MGH) was founded in 1811,

making it the third oldest hospital in the United States. With 907 patient beds across a 4.6 million

square-foot campus and almost 23,000 employees, it was one of the largest hospitals in the country

and Boston’s largest private employer. U.S. News & World Report consistently ranked MGH as

one of the top five hospitals in the nation, and patients traveled from all over the country to

receive treatment there. It was also home to the Ether Dome, an amphitheater that served as MGH’s

first operating room (OR) and became the birthplace of anesthesia when ether was first publicly

administered there as a surgical anesthetic in 1846. 2

The PATA Mission

The risk of administering anesthesia had decreased significantly since the early 1990s due to major

strides in research and technology. Risks were still present, however, and complications could result

in permanent disability or death. Doctors, therefore, needed to know before surgery that a patient’s

system was strong enough to endure anesthesia. All surgery patients were therefore required to have

a “pre-admission work-up”. The Pre-Admission Testing Area (PATA) clinic was responsible for

completing work-ups for all out-patients,3 which accounted for 43% of all surgical patients.

Challenges in PATA

PATA was an outpatient clinic with 12 exam rooms, a lab, and a waiting room. (See Figure 1.)

Patients typically spent about 80-90 minutes of face time with providers in PATA, but even in

1

This is a stripped-down version of the original case. The original case was prepared by Kelsey McCarty, MBA

Class of 2010, Jérémie Gallien, Associate Professor of Management Science and Operations, London Business

School, and Retsef Levi, Associate Professor of Management, MIT Sloan...