Health chiefs in the Highlands are continuing to take advice from US experts who base their philosophy for healthcare on practices used in the Japanese car industry.
Managers are maintaining their links with the Virginia Mason Institute in Seattle despite a previous outcry over the cost to Scottish taxpayers of flying staff to America twice – to teach them how to be more efficient.
The Press and Journal revealed three years ago that NHS Highland spent more than £18,000 on the trips while struggling to balance its budget.
Politicians and a patient representative condemned the idea as a drain on public money.
NHS Highland’s “director of quality improvement” Linda Kirkland will update colleagues on the board’s “Highland Quality Approach” initiative at a board meeting next week.
She will inform them about a two-day visit to the Highlands in January by the institute’s director Diane Miller.
Ms Kirkland will inform colleagues about “areas of strength” identified by the institute and recommendations it has proposed.
The medical facility in Seattle is regarded as one of the top performers in the US because of healthcare methods based on a “Toyota production system” devised by the Japanese car maker.
Its philosophy is one of improving healthcare and efficiency by eliminating waste, including time, space and materials.
NHS Highland chairman Garry Coutts has defended the initiative, claiming it has achieved “massive improvements” to healthcare in the US.
Ms Kirkland will also highlight priority areas for 2015-16, patient flow, out-of-hours services, adult health and social care services in the community and transforming services for patients in the Highlands’ rural hospitals.
The board is to establish a steering group to oversee the work in each area.
“The greatest challenge,” Ms Kirkland states in a board briefing, “is to influence hearts and minds, to get more people trained in quality improvement delivering quality improvement and demonstrating behaviours (sic) consistent with our values.”