3C-09 - Exploring the Impact of Implementing Automated Dispensing Cabinet Systems on Patient Safety and Human Resource Management in Inpatient Pharmacy Service at a Medical Center in Taiwan

Background: Healthcare personnel shortages contribute to medication errors and lower care quality. The implementation of health information technology, such as automated dispensing cabinets (ADCs), can mitigate these issues. Taiwan has recently begun ADC implementation, with medical centers leading adoption.

Objectives: To evaluate the impact of ADCs on patient safety and healthcare personnel workload in Taiwan.

Methods: We conducted a retrospective study in a medical center in Taiwan transitioning from a centralized unit dose system to ADCs since 2020, covering ~80% of common ward medications by ADCs in some wards. The study compared two periods: pre-ADC (2019) and post-ADC (September 2024). We compared the two periods using hospital database and medication error reporting systems built by the IT department, analyzing the impact of ADC implementation on pharmaceutical service volume, medication errors, and human resource allocation. A time study quantified workflow changes. Chi-squared and t-tests were used, with adjusted odds ratios and 95% confidence intervals calculated.

Results: After analysis, 36% of inpatient beds were covered by ADCs post-implementation. Following the implementation of ADCs, the daily number of medication orders prepared via medication carts or online dispensing, and the number of medication returns, significantly decreased. Hospital-wide, daily medication cart orders decreased by 33%, online dispensing by 30%, and medication returns by 34%. In ADC-equipped wards, the reductions were more pronounced, with decreases of 72%, 71%, and 65%, respectively. The number of manual drugs transportation also decreased 52%.

Regarding medication errors, the hospital’s pre-ADC quarterly dispensing error rate was 0.032‰, which declined to 0.021‰ from 2021 to 2023, and further to 0.018‰ in 2024 (p < 0.05). This demonstrates a significant reduction in dispensing errors following ADC adoption. Notably, in the ADC-equipped wards, only one dispensing error was related to ADCs due to a new staff member's unfamiliarity with the system.

In terms of human resource efficiency, the daily time spent on existing workflows related to dispensing, verification, transportation, and medication returns was reduced by 66.08 hours—equivalent to approximately 8.3 full-time personnel hours following ADC implementation. This saved workforce can be reallocated to clinical services, ADC maintenance, patient education, and other related tasks.

Conclusions: ADCs improved pharmaceutical service efficiency, reduced medication errors, and optimized human resource allocation.