Impact of automated dispensing cabinets on medication administration efficiency in the emergency department

Cheng-Ying Chiang; Chia-I Cheng; Yen-Wen Chen; Jian-Heng Lee; Ya-Ni Yeh; Jih-Chun Lin; Hsin-Yi Yang; Chung-Hsien Liu; Ming-Jen Tsai

doi:10.1186/s12873-026-01600-0

Impact of automated dispensing cabinets on medication administration efficiency in the emergency department

BMC Emerg Med. 2026 Apr 30. doi: 10.1186/s12873-026-01600-0. Online ahead of print.

Authors

Affiliations

¹ Department of Emergency Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, No. 539, Zhongxiao Road, East District, Chiayi City, 600, Taiwan.
² Clinical Data Center, Department of Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City, Taiwan.
³ Department of Emergency Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, No. 539, Zhongxiao Road, East District, Chiayi City, 600, Taiwan. tshi33@gmail.com.

^# Contributed equally.

PMID: 42062898
DOI: 10.1186/s12873-026-01600-0

Abstract

Background: Timely medication administration in emergency departments (EDs) is essential for optimal patient outcomes. Automated Dispensing Cabinets (ADCs) may improve point-of-care medication access, yet their impact on administration timeliness is uncertain in ED settings.

Objective: To evaluate the association between ADC implementation and the timeliness of stat medication administration in a high-volume ED in Taiwan.

Methods: We conducted a retrospective observational study analyzing 16,450 adult ED visits from July-August 2019 (pre-ADC) and July-August 2020 (post-ADC). Order-to-administration (OTA) times for stat medications were compared. Multivariable logistic and linear regression analyses evaluated the association between ADC implementation and timely medication delivery. Sensitivity analyses, including a difference-in-differences model and survival analysis using Kaplan-Meier curves and multivariable Cox regression, were performed to evaluate the robustness of findings.

Results: After adjusting for potential confounders, ADC implementation was independently associated with higher odds of achieving OTA times ≤ 30 min (adjusted odds ratio [aOR], 1.59; 95% confidence interval [CI], 1.42-1.78). Linear regression showed a mean reduction in OTA time of 3.09 min per prescription (β = - 3.09; 95% CI, - 3.58 to - 2.60). Subgroup analyses showed that ADC implementation was associated with higher odds of achieving OTA ≤ 30 min and shorter OTA times for antibiotics (aOR, 2.19; 95% CI, 1.54-3.12; β = - 4.99; 95% CI, - 7.03 to - 2.94), as well as during daytime (aOR, 1.87; 95% CI, 1.58-2.21; β = - 4.34; 95% CI, - 5.26 to - 3.41) and weekend shifts (aOR, 1.66; 95% CI, 1.34-2.05; β = - 3.48; 95% CI, - 4.30 to - 2.65). Findings from sensitivity analyses were consistent with the primary results.

Conclusion: ADC implementation In the ED was associated with modest but operationally meaningful improvements in medication administration timeliness. These findings may be context-dependent and warrant confirmation across diverse workflows and with patient-centered and safety outcomes.

Clinical trial number: Not applicable.

Keywords: Automated dispensing cabinets; Emergency care efficiency; Emergency department; Medication administration; Order-to-administration time.