Appraising the Clinical, Operational, and Economic Impacts of Automated Medication Dispensing Cabinets in Perioperative and Surgical Settings: A Systematic Literature Review.

ABSTRACT

BACKGROUND: Initiation of pharmacy automation and automated dispensing cabinets (ADCs) in hospitals has shown to improve clinical, operational, and economical outcomes. Implementation of ADCs in surgical areas has lagged behind that of traditional hospitals settings. OBJECTIVES: To assess the documented impact of ADCs in ambulatory surgery centers (ASCs), perioperative, and surgical care areas. METHODS: A systematic literature review (SLR) was conducted in PubMed and Google Scholar in November 2022. The SLR was performed and reported according to the PRISMA guidelines. Original research studies were included if they reported empirical data on ADCs in ASCs, perioperative areas, and surgical settings. The search criteria consisted of site locations in North America or Europe, with articles written in English and published after 1992. Outcomes of the studies were categorized as medication errors, controlled substance discrepancies, inventory management, user experience, and cost effectiveness. RESULTS: A total of nine studies met the inclusion criteria. Six assessed ADC impact on controlled-substance inventory management, with all finding reductions in controlled-substance discrepancies ranging from 16% to 62.5%. Two studies showed a reduction in medication errors from 23% in one study to up to 100% after ADC implementation in the other. Three studies revealed a positive impact on user experience, with a range of 81%-100% of nurses across these settings being satisfied with ADC usage. Only one study showed post-ADC implementation labor cost savings due to reduction in labor hours but was based on data from three decades ago. CONCLUSIONS: ADC implementation in surgical settings was found to decrease medication errors, reduce controlled-substance discrepancies, improve inventory management, increase user experience, and reduce labor hours although the evidence consisted of smaller-scale studies. Larger-scale studies are needed to support these findings, thereby fostering a more comprehensive view of the multifactorial impact of ADCs in these settings.