Introduction Many hospitals choose to use certain tools related to lean, such as visual management (VM) during organizational development (OD) and daily processes. By using VM in the strategic planning process and depending on what is visualized in what stage of the planning process, different cognitive, social and emotional benefits may be gained. Research on VM in healthcare has so far concerned case studies of VM in surgical departments or during OD, and there is a lack of studies with rich empirical data. The aim of this paper was to explore VM use at hospital units undergoing OD; the main VM focus, and the benefits and perceived VM contributions concerning working conditions and efficacy. Material and Methods Photos of VM (120) at 16 units were taken during 2013-2015 and categorized by content analysis into VM focus and main content. A questionnaire concerning use of and perceived VM contributions in daily work (regarding; a) overview work, b) focus important information, c) detection of improvement opportunities) as well as working conditions, efficacy and quality of care was distributed to registered nurses and assistant nurses at five hospitals (21 units) at two occasions, 2013 (N=926) and 2014 (N=632). Comparative analysis’ within and between higher and lower use units were conducted. Results Content analysis of the photos showed three main VM foci; results, flow and improvements.  Five of the 21 units were considered to have higher VM and 16 units had lower. In comparative analysis, higher VM was associated with higher predictability and influence as well as with cognitive and social benefits of importance when participating in OD. Higher VM was also associated with higher degree of goal monitoring and evaluation, patient flow and efficacy in health care service. Conclusions Daily use of VM in hospitals undergoing OD had importance for employees’ working conditions as well as  perception of OD; overview of work, focus on results,  detection of improvement opportunities and outcomes in terms of patient flow and efficacy.