Massachusetts General Hospital's Pre-Admission Testing Area (PATA)

Kelsey McCarty

Kelsey McCarty talks about her MIT Sloan School of Management case, Massachusetts General Hospital's Pre-Admission Testing Area (PATA). The case, co-authored with Jérémie Gallien, London Business School and Retsef Levi, MIT Sloan School of Management, won the New Case Writer category at the ecch Case Awards 2012.

The Pre-Admissions Testing Area (PATA) is an outpatient clinic at Massachusetts General Hospital (MGH) responsible for conducting pre-operative assessments of surgical patients prior to their procedures. The case describes the conditions of this busy outpatient clinic prior to a process improvement effort by a collaborative team of MIT Sloan students and faculty, and MGH clinicians and administrative staff. It looks at the complete PATA experience from both the patient and provider perspective. The importance of improving PATA is emphasized by examining how this relatively small clinic has a very large downstream effect on the MGH operating rooms and the entire perioperative care system.

Why this subject?

I attended the MIT Sloan School of Management with a focus on developing business skills that I could apply to a career in hospital management. Retsef Levi was my Data, Modelling, and Decisions course professor in my first semester and had been engaged in a long-standing collaboration between MIT and MGH. He introduced me to Susan Moss of MGH (who is featured in the case) and she invited me to do a summer internship in the Department of Anesthesia, which has oversight of PATA.

As part of the collaborative team of MIT Sloan students and MGH staff working on the PATA project I drew from many of the concepts I learned in my Operations Management class at MIT. In fact, the approach to the problem had a lot of parallels to how we approached cases and problems in the course. Jérémie Gallien was my Introduction to Operations Management professor before I started my internship and I sought him out to make sure I was applying the tools from his class to PATA correctly.

As a result of our discussions Jérémie suggested that the project would make a great case. The need to improve efficiency in healthcare delivery is a hot topic right now and he thought the example from this clinic at MGH would be not only a great learning tool for operations management principles, but also a very relevant and interesting way to study them. Jeremie, Retsef and I began writing the case that fall.


PATA is actually much more complex than what is presented in the case, but we wanted to keep the case at a manageable page length and be able to assign homework questions that wouldn’t take weeks and sophisticated modelling software for students to solve (which is what we needed to analyse the real PATA). In simplifying though, we also wanted to stay true to the real issues and challenges in PATA and not take too much creative license. It took many drafts, but I feel confident that we accomplished that. Personnel at MGH who have read the case have expressed that it definitely touches home on the situation in PATA and the challenges they were experiencing.

Using the case

From a quantitative perspective, the case serves as a great study tool for students to learn how to create process maps, build-up diagrams and apply queuing theory for an operations management course. From a qualitative perspective, it provides excellent material for a rich discussion on re-engineering. The case exposes students to concrete operational challenges in health care delivery, and illustrates both the application and the potential benefits of quantitative process analysis and process reengineering in this environment.

Any advice for case writers?

Share the case with lots of reviewers and be prepared for a lot of editing! It was important to us that the physicians, nurses, and administrators involved directly with PATA, and the MGH senior leadership, felt that the case accurately portrayed the PATA clinic and MGH as a whole. We therefore asked many people to help with reviewing. We probably went through at least 25 versions of the case as a result, but I think the final product was worth it. We’re really proud of this work and our award from The Case Centre, as are many people from MGH.

Case details

Massachusetts General Hospital's Pre-Admission Testing Area (PATA)
Kelsey McCarty, Massachusetts General Hospital
Jérémie Gallien, London Business School
Retsef Levi, MIT Sloan School of Management
Ref 11-116
Also available:
Teaching note
Ref 11-127TN
This case is part of the MIT Sloan free case collection.

About the authors

Kelsey McCarty is Senior Operations Manager at Massachusetts General Hospital, US.

Jérémie Gallien is Associate Professor of Management Science and Operations at London Business School, UK.

Retsef Levi is the J. Spencer Standish (1945) Professor of Management, Associate Professor of Operations Management at MIT Sloan School of Management, US.

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