Application of Lean Visual and “6S” Management Concept in Clinical Nursing

Figures & data

Table 1 Comparison of Nurses’ Satisfaction with the Work Environment Before and After the Visual and “6S” Management

Time	Before“6S” (n[%])	After“6S” (n[%])	P
n	174	174	<0.01
Very Satisfied	106 (60.78%)	150 (86.06%)
Quite Satisfied	34 (19.68%)	22 (12.36%)
General	26 (15.23%)	1 (1.44%)
Unsatisfied	8 (4.31%)	1 (0.14%)

Note: the terms “before ‘6S’” and “after ‘6S’” refer to the short form of before and after implementing the Visual and “6S” Management.

Figure 1 The difference of the working environment before and after the implementation of the Visual and “6S” Management. (A and B) shown the environment before the method was implemented, (C and D) shown the environment after the method was implemented.

Table 2 Comparison of Warehouse Inventory Time in Each Ward Before and After Implementing the Visual and “6S” Management

Department	Before“6S” Min (Mean±SD)	After“6S” Min (Mean±SD)	t	P
Intensive care unit	21.0±1.87	15.0±1.58	4.9	0.003
Urology	16.93±2.80	13.25±2.42	1.98	0.095
Ward Eight	12.03±0.54	11.23±0.46	1.11	0.329
Cardiology	11.15±0.74	10.18±0.22	2.52	0.045
Orthopedics	30.5±0.24	23.7±0.31	16.83	<0.001
Gynecology	24.75±3.14	9.9±0.83	4.56	0.004
Hemodialysis Room	10.38±0.15	8.3±0.14	20.13	<0.001
Operating Room	11.23±0.20	10.2±0.14	4.11	0.006
Brain Surgery	20.93±2.31	10.03±0.20	8.13	0.001
Encephalopathy 1	13.85±0.59	8.58±0.63	12.11	<0.001
Encephalopathy 3	13.68±0.49	8.25±0.23	19.84	<0.001
Emergency	11.00±0.81	8.25±0.95	4.37	0.005
Surgery	17.23±0.81	14.98±0.93	3.63	<0.001

Note: the terms “before ‘6S’” and “after ‘6S’” refer to the short form of before and after implementing the Visual and “6S” Management.

Table 3 Comparison of Material Inventory Time in Each Ward During Shift Hand-Over Before and After Implementing the Visual and “6S” Management

Department	Inventory Time (Min)		t	P
	Before “6S” (Mean±SD)	After “6S” (Mean±SD)
ICU	8.18±2.47	6.38±0.47	1.3	0.241
Urology	4.55±0.16	2.98±0.24	10.67	<0.001
Ward Eight	13.67±1.65	10.72±0.34	3.48	0.013
Cardiology	24.13±4.70	10.89±1.03	5.49	0.002
Orthopedics	20.76±1.84	17.8±0.49	3.1	0.021
Gynecology	5.12±0.49	3.82±0.94	2.44	0.05
Hemodialysis Room	3.65±0.49	2.29±0.09	3.83	0.062
Operating Room	26.18±5.20	10.26±0.26	6.11	<0.001
Brain Surgery	31.93±2.13	9.01±0.84	17.32	<0.001
Encephalopathy 1	24.27±4.27	19.28±5.82	1.38	0.216
Encephalopathy 3	16.80±1.88	5.37±0.24	12.01	<0.001
Emergency	14.00±1.41	9.94±0.57	5.32	0.002
Surgery	9.03±4.65	7.04±0.54	0.85	<0.001

Note: the terms “before ‘6S’” and “after ‘6S’” refer to the short form of before and after implementing the Visual and “6S” Management.

Table 4 Comparison of the Incidence of Nursing Adverse Events Before and After “6S” Combined with Visual Management

Variables	Hospitalized Patients	Medication Errors	Incidence (%)	χ^2	p
Before“6S”	28,164	10	3	0.001	<0.001
After“6S”	23,547	2	1

Note: the terms “before ‘6S’” and “after ‘6S’” refer to the short form of before and after implementing the Visual and “6S” Management;

Table 5 Comparison of ICU Rescue Efficiency and Time Before and After “6S” Combined with Visual Management

Variables	n	Time Taken to the Following Procedures (Seconds)
		Airway Opening(s)	CVC Item Preparation(s)	Ventilator Items(s)
Before “6S”	83	368.73±65.62	421.99±70.83	278.07±50.78
After “6S”	88	150.70±30.56	139.6±25.23	114.72±13.87
t		28.11	35.12	29.05
P		<0.001	<0.001	<0.001

Note: the terms “before ‘6S’” and “after ‘6S’” refer to the short form of before and after implementing the Visual and “6S” Management; s, second;

Table 6 Comparison of Rescue Efficiency and Time in the Emergency Department Before and After “6S” Combined with Visual Management

Variables	n	Time Taken to the Following Procedures (Seconds)
		Time to First Electrocardiograph	Time to Establish Venous Access	Time of First Dose
Before“6S”	32	266.81±16.42	214.81±24.09	125.25±7.41
After“6S”	34	93.18±12.25	105.21±7.98	111.18±13.62
t		48.88	25.15	5.17
P		<0.001	<0.001	<0.001

Note: the terms “before ‘6S’” and “after ‘6S’” refer to the short form of before and after implementing the Visual and “6S” Management.