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Case Studies & Testimonials

Examples of our Work

We hope the following selection of case studies will give you a sense of how our services have benefited other clients’ perioperative systems.

Case Study #1: Design of a Central Sterilization Facility at a Metropolitan Hospital


A metropolitan hospital, anticipating very substantial growth in case load, wished to know whether the existing footprint of its central sterilization department could accommodate the equipment, people, storage and cart staging area demanded by the growth. By keeping the department in its existing location, the hospital anticipated saving “millions” of dollars.


Twin Peaks Group began by enlisting the assistance of the manufacturer of most of the equipment in the central sterile department to provide data and information on current and upcoming equipment – cart washers, washers and sterilizers. Then, using a model for the arrival rate of soiled carts in central sterile as a function of time of day, we derived arrival rates for trays and carts, etc. Finally, using data on processing rates for equipment, we calculated the number of pieces of equipment required and concluded that the equipment would fit into the existing area. We applied analogous models to the needs for storage and for cart staging.

Outcome for the Hospital

The hospital concluded that it would not need to move the facility to a new area, thereby avoiding an expense of “millions” of dollars.

Outcome for the Technology Company

The technology company tightened its relationship with the hospital and went on to build an analytic model – similar to that developed by Twin Peaks Group – for use by its sales organization.

Case Study #2: Reducing Non-Operative Time at a Metropolitan Hospital


The manufacturer of a system of mobile OR tables had sold its first U.S. system to a large hospital and had coached the hospital on its use. The new process did not catch on, leaving the hospital with little to show for its investment in an innovative technology and the vendor without a US-based reference site.


Twin Peaks Group organized a project using a team of clinicians and other staff, guided by a steering group consisting of managers and led by the chief surgeon. The problem was re-cast in terms of reducing Non-Operative Time from 65 minutes to 40 minutes. To achieve the goal, processes were redesigned throughout the perioperative system, in part to achieve more parallel processing, and some simple technology was introduced. After developing a training program and performing dry runs, the process was introduced into two ORs performing short cases.

Outcome for the Hospital

Within three weeks of introducing the changes, the Non-Operative target was attained, yielding the opportunity to add one case per day without increasing resources. The annual value was estimated to be about $500,000. In addition, the clinical leaders published an article in Surgery, which received favorable comments.

Outcome for the Technology Company

The success of the project and the enthusiasm of the perioperative staff created a referral site that resulted in three new customers in six months. The experience also led the technology company to revise its value proposition and its sales and implementation processes for the system.

Case Study #3: Patient Flow from the Emergency Department to an Inpatient Unit


A community hospital had launched a program to improve the flow of patients from the ED to inpatient beds. After struggling with the problem for several months, the Vice President of Nursing turned to Twin Peaks Group for assistance. We showed her how to break down the problem into manageable phases, beginning with the easiest and progressing to the most difficult. By attacking the overall problem using this strategy, the nurses would develop skills and confidence to tackle the progressively more challenging steps.


Twin Peaks Group recommended focusing first on the time required to move patients to a bed when a bed was available, and concentrated initially on reducing the floors’ response time to a bed request from the ED. We formed a cross-organizational team and introduced a closed-loop communication method to ensure that requests were acknowledged. We also introduced the team to project management and process improvement methods.

Outcome for the Hospital

The team reduced the average response time to 40% of its then current value. More importantly, the project created the foundation for further improvement and extension of the scope of the program.

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  • Testimonials

    “Your most important contribution? You affected a (positive) cultural shift here.”

    Chief of Anesthesia

    "I still encourage and teach new staff on the improvement processes that were put in place when you were here. Many are still in place and I believe our stats for first case and turnover time have improved because of your work with us.”

    Perioperative Services Director (RN)

    “Prior to TPG, we’d had repeated, bad experiences with consultants. Twin Peaks Group changed all that.”

    Chief of Surgery

    "You guys were on the ground with me - working. You wanted to see results!"

    Anesthesiology Team Leader

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