January 3, 2012
Massachusetts General Hospital's Pre-Admission Testing
Kelsey McCarty, Jérémie Gallien, Retsef Levi
Five anxious faces looked up at Dr. Jeanine Wiener-Kronish, chief of anesthesia at Massachusetts General Hospital (MGH), as she entered the conference room. It was June 2009, and the group before her was the task force for the Pre-Admission Testing Area (PATA). PATA had been struggling with inefficiencies and long patient wait times for over two years. Despite the group’s best efforts to fix these problems, a letter forwarded from the president’s office that morning highlighted that conditions in PATA were not getting better. Dr. Wiener-Kronish took a seat and read the letter aloud: Last week I brought my mother into the Pre-Admission Testing Area. We live almost 3 hours away and had to make a special trip for this appointment, which her oncologist, Dr. Paul Schneider, said was necessary to ensure a safe and successful surgery.
When we arrived at the clinic, the waiting room was so full, it was five minutes before my mother and I could get two seats together. We sat there for a full half-hour before they sent us back to get her blood pressure reading. We then waited back in the waiting room for another 45 minutes before being moved to an exam room. It was 20 minutes before a nurse finally came in and she mostly just asked questions I had already answered on a form provided by the front desk. After the nurse left, it was almost another half-hour before the doctor finally came in and he also asked many of the same questions. The providers were very nice and apologetic, but of the almost 4 hours we spent in the clinic, only 1½ hours of that was actually face time with anyone! Even more aggravating, while my mother was in surgery this morning, two families in the waiting room said their relatives never even had to have a PATA appointment. One even had the same condition as my mother so I’m not sure why our PATA visit was even necessary.
This 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 School of Management.
Copyright © 2012, Kelsey McCarty, Jérémie Gallien, and Retsef Levi. This work is licensed under the Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 Unported License. To view a copy of this license visit http://creativecommons.org/licenses/by-nc-nd/3.0/ or send a letter to Creative Commons, 171 Second Street, Suite 300, San Francisco, California, 94105, USA.
MASSACHUSETTS GENERAL HOSPITAL'S PRE-ADMISSION TESTING AREA (PATA) Kelsey McCarty, Jérémie Gallien, Retsef Levi
I brought my mom from out-of-state because we were told that Mass General provides the best care in all of New England, maybe even the country, but that’s not at all what we experienced. I sincerely hope that we can expect more from our next visit to MGH.
Dr. Slavin, president of MGH, had a dedicated department to process letters from patients, families, and friends. The majority of these letters were filled with overflowing gratitude for the quality of care delivered by the hospital and its employees. Therefore, when letters like this came across his desk, they were not taken lightly. Dr. Wiener-Kronish knew she needed to correct the problems in PATA quickly.
Anesthesia at MGH
Dr. Jeanine Wiener-Kronish began her career in anesthesia as a resident at the University of California at San Francisco (UCSF) and went on to become a skilled attending physician,1 researcher, and director of the Pre-Operative Program. In 1999, she achieved great renown for discovering a vaccine for an infection associated with prolonged ventilator usage. This infection was the leading cause of death in the intensive care unit (ICU). In 2008, ready for her next challenge, Dr. WienerKronish accepted the position of anesthetist-in-chief at MGH,...
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