A hospital appointment has led to carmaker Nissan's plant in Sunderland teaching German medics how to improve their efficiency.
When a Nissan Europe manager spotted Quality Control certificates on his doctor's wall in St Johennes Hospital, near Cologne, Germany, he suggested the hospital could benefit from a new efficiency course Nissan was rolling out to its car dealers.
After making enquiries, hospital technician Anne Zimmerman learnt that Sunderland Royal Hospital had already benefited from Nissan's know-how, and arranged a visit to the North-East.
Now, following a fact-finding trip to the Nissan plant, and to Sunderland Royal's day case unit, Anne is taking a range of efficiency improvement ideas back to her colleagues in Germany.
Dominic Lydon, training senior controller at Nissan, said: "We were originally approached by City Sunderland Hospitals to see how aspects of our lean manufacturing programme could be introduced into the healthcare sector.
"We took them through `Project SX' which is a course designed to introduce aspects of manufacturing best practice, such as standard operations and waste elimination, into our dealer workshops.
"Based on this, Sunderland Royal implemented changes, making it more efficient and significantly reducing waiting times in its day care unit."
Anne Zimmerman was taken through the course before speaking to Sunderland Royal staff about the improvements they had made.
She said: "I was very impressed with the ideas contained in the Nissan course.
"Although it was designed for manufacturing, there were lots of efficiency improvements that could be applied to hospital work."