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The Pre-Admissions Testing Area (PATA) is an outpatient clinic at Massachusetts General Hospital responsible for conducting pre-operative assessments of surgical patients prior to their procedures. This case study 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. The case describes the complete PATA experience from both the patient and provider perspective. The importance of improving PATA is emphasized through a description of how this relatively small clinic has a very large downstream effect on the MGH operating rooms (ORs) and the entire perioperative care system. The learning objective is to expose students to concrete operational challenges in health care delivery, and illustrate both the application and the potential benefits of quantitative process analysis and process reengineering in this environment. Could be taught in operations management and healthcare operations courses. This case is part of the MIT Sloan free case collection (visit www.thecasecentre.org/mitsloanfreecases for more information on the collection).