Impact of automated dispensing cabinets on dispensing errors, interruptions and pillbox preparation time
Open accessAbstract
AIM: This work aimed to evaluate the impact of automated dispensing cabinets on the dispensing error rate, the number of interruptions, and pillbox preparation times. METHODS: A prospective observational study was conducted across 16 wards in two departments (internal medicine and surgery) of a large teaching hospital. The study compared eight wards using automated dispensing cabinets (ADCs) and eight using a traditional ward stock (TWS) method. A disguised observation technique was used to compare occurrences of dispensing errors and interruptions and pillbox preparation times. The proportion of errors was calculated by dividing the number of doses with one or more errors by the total number of opportunities for error. Wards participating in the 'More time for patients' project-a Lean Management approach-were compared with those not participating. The potential severity of intercepted errors was assessed. RESULTS: Our observations recorded 2924 opportunities for error in the preparation of 570 pillboxes by 132 nurses. We measured a significantly lower overall error rate (1.0% vs 5.0%, p=0.0001), significantly fewer interruptions per hour (3.2 vs 5.7, p=0.008), and a significantly faster mean preparation time per drug (32 s vs 40 s, p=0.0017) among ADC wards than among TWS wards, respectively. We observed a significantly lower overall error rate (1.4% vs 4.4%, p=0.0268) and a non-significantly lower number of interruptions per hour (3.8 vs 5.1, p=0.0802) among wards participating in the 'More time for patients' project. CONCLUSIONS: A high dispensing-error rate was observed among wards using TWS methods. Wards using ADCs connected to computerised physician order entry and installed in a dedicated room had fewer dispensing errors and interruptions and their nurses prepared pillboxes faster. Wards participating in a Lean Management project had lower error rates than wards not using this approach.
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Nurses experienced less interruptions such as colleague speaking, reduced from 5.7 pre-ADC to 3.2 post-ADC (p = 0.0008) per hour.
“It was also reported that nurses experienced less interruptions such as colleague speaking reduced from 5.7 pre-ADC to 3.2 post-ADC (p = 0.0008) per hour.31”
From Benefits and challenges associated with implementation and ongoing use of automated dispensing cabinet for medicines: A scoping review (2025) · cites this paper as [31]
The ‘Impact of ADCs on interruption’ section reports 3.2 interruptions per hour in ADC wards versus 5.7 in traditional-ward-stock wards (p=0.0008). It identifies ‘colleague speaking’ as a common type, but those rates are for all interruptions, not that type specifically. The study compared ward groups rather than measuring a pre-ADC and post-ADC change. (LLM, conf=0.90)
Experimental — accuracy not yet measuredJumeau et al. reported that ADC implementation reduced number of error rates from 5.0% to 1.0% (p = 0.0001).
“Jumeau et al. further reported that ADC implementation reduced number of error rates from 5.0 % to 1.0 % (p = 0.0001).31”
From Benefits and challenges associated with implementation and ongoing use of automated dispensing cabinet for medicines: A scoping review (2025) · cites this paper as [31]
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Jung, Y. Y., Walsh, Á., Patel, J., & Lai, K. (2025) · Exploratory Research in Clinical and Social Pharmacy · doi:10.1016/j.rcsop.2025.100599 · Cited by 7 · see citing works
- Authors
- Jumeau, M., Francois, O., & Bonnabry, P.
- Affiliations
- University of Geneva (CH)
- University Hospital of Geneva (CH)
- Corresponding author
- Jumeau, Margaux
- Venue
- European Journal of Hospital Pharmacy
- Publisher
- BMJ
- Published
- 2021-08-23
- Volume
- 30
- Issue
- 4
- Pages
- 237-241
- ISSN
- 2047-9956 (ISSN-L)
- 2047-9964
- PMC
- PMC10359777
- OpenAlex
- W3138766005
- Cited by
- 13
- References
- 1
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 3 · 2023: 2
- FWCI
- 1.53
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- European Journal of Hospital Pharmacy (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Health Sciences › Health Professions › Occupational Therapy › Safe Handling of Antineoplastic Drugs
- Keywords
- automated dispensing cabinets, medication dispensing errors, interruptions, lean manufacturing, computerized physician order entry, error rate
- MeSH terms
- Hospitals, Teaching, Humans, Medication Errors, Medication Systems, Hospital, Prospective Studies, Medical Order Entry Systems
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