IMPROVING OCCUPATIONAL HEALTH AND PATIENT SAFETY THROUGH AN AUTOMATED MULTIDOSE DISPENSING SYSTEM
European Statement
Clinical Pharmacy Services
Author(s)
P. Frandsen
M. Nissen
C. Olesen
Why was it done?
Medicines dispensed by an automatic multidose dispensing system (ADS) was introduced on an orthopaedic surgery ward to improve the occupational health of pharmacy technicians. The hope was to release time for medication reconciliation, allowing pharmacy technicians to use their professional skills in supporting the orthopaedic surgeons and enhancing patient safety.
What was done?
In the orthopaedic surgery ward, pharmacy technicians manually dispensed medication to inpatients and upon discharge. Prior to dispensing, they compared prescriptions in the hospital electronic patient journal to prescriptions patients receive at home. In case of discrepancies, the orthopaedic surgeon was contacted to make any necessary changes.
Due to pharmacy technicians’ occupational health being affected by long hours dispensing medicines, medicines dispensed by an ADS was introduced. Per agreement with the chief surgeon, pharmacy technicians took on expanded responsibilities, including authority to independently adjust certain prescriptions.
How was it done?
Pharmacy technicians were asked to register time used dispensing medicines and time used reviewing prescriptions before the workflow changes and again after six months.
Semi-structured interviews were conducted with the six pharmacy technicians involved before the workflow changes and again after six months.
What has been achieved?
Total pharmacy technician time spent dispensing medicines per day was reduced from 326 minutes (range: 175–546) to 203 minutes (range: 105–358).
Time spent on prescription review per day increased from 44 minutes (range: 18–77) to 93 minutes (range: 30–170).
Before introducing the ADS, several pharmacy technicians reported physical strain in their hands and mental fatigue after long hours of dispensing.
After the introduction of the ADS, there was a marked improvement in occupational health. Pharmacy technicians, who had experienced strain in their hands noticed improvement, and half of them also reported reduced mental fatigue.
Collaboration with surgeons was mentioned by pharmacy technicians as problematic before the new workflows but significantly improved, with pharmacy technicians feeling their expertise was appreciated by surgeons and ward staff.
What next?
Across Denmark, pharmacy technicians spend hours dispensing medicines in hospital wards. Implementing an ADS could relieve pharmacy technicians, improve occupational health and allow pharmacy technicians to focus on other tasks such as medication reconciliation, which would enhance patient safety.
BUILDING A ZERO-ERROR MEDICATION WORKFLOW THROUGH SMART DISPENSING SYSTEMS AND BIG DATA GOVERNANCE
European Statement
Patient Safety and Quality Assurance
Author(s)
Hui-Yu Chen, Kai-Cheng Chang
Why was it done?
Medication safety remains a cornerstone of healthcare quality, yet adverse drug events (ADEs) continue to cause preventable harm in hospitals. Traditional manual dispensing workflows, dependent on human memory and paper-based checks, are prone to errors, particularly in large medical centers with high prescription volumes.
What was done?
We launched the “Smart Dispensing and Data Governance Project,” aiming to transform the pharmacy workflow through digitalization and data-driven quality management.
How was it done?
A two-pronged strategy was adopted: (1) deployment of smart dispensing hardware and (2) establishment of a big data governance platform. The hardware featured personalized login for accountability, closed-loop barcode verification of both medications and prescription bags, LED guidance and voice feedback for real-time alerts, and final barcode validation before dispensing. Advanced automation such as real-time stock sensing, weight-based verification, and image-assisted accuracy checks further minimized human errors. A SAS Visual Analytics–based Business Intelligence dashboard visualized error trends and enabled continuous PDCA (Plan-Do-Check-Act) improvement cycles through near real-time feedback.
What has been achieved?
Implementation led to substantial quality improvements: the dispensing error rate decreased by 78.3% (0.023‰ to 0.0050‰, P < 0.05); data analysis time for error monitoring shortened from 4 hours to 10 minutes (-98.3%, P < 0.05); and pharmacist training time reduced from 10 days to 3 days (−60.0%). All indicators showed statistically significant enhancement in accuracy and efficiency. Integrating smart dispensing systems with big data governance effectively advanced medication safety and operational efficiency. This model established a scalable, data-driven, and high-reliability pharmacy workflow, transforming quality management from reactive correction to proactive prevention and serving as a replicable benchmark for digital hospital transformation.
What next?
We plan to apply AI algorithms to dynamically optimize drug storage locations based on usage and safety risk, and to digitalize all storage displays through an integrated electronic shelf–label system. These enhancements will further strengthen accuracy, reduce human-factor variability, and advance a highly reliable smart dispensing workflow.
Hospital pharmacists pioneering in installation of an automated dispensing system in General Public Hospital, Chania, Greece
Pdf
European Statement
Selection, Procurement and Distribution
Author(s)
Marinos Petrongonas, Maria Fragiadaki, Eleni Rinaki, Leonidas Tzimis
Why was it done?
HPs were facing challenges related to:
• Stuff shortages in a high risk environment with increasing uncertainty
• Implementation of Directive 2001/83/EC on Falsified Medicines; deadline for Greece is 2025
• Medicines’ shortages for which optimal inventory management procedures are needed • Patient safety and quality of pharmaceutical services: quality assurance processes, medicines’ traceability, monitoring expiration dates and respond-time to ward’s requests
What was done?
During the last 2 years, hospital pharmacists (HPs) actively participated in the supply, installation and functional integration of the first Automated (Robotic) Dispensing System (ADS) in Greece, in Chania General Hospital (CGH). It is a centralised distribution system installed in the pharmacy department which receives, stores and distributes packages of medicines.
It has a storage capacity of approximately 20,000 packages, including one robotic arm, three distribution exits, two loading ways (semi- and fully-automated), with software comprised. Speeds range from 200 to 900 for loading and 350 to 760 packages/hour for unloading. Under HPs’ direction, medicine management procedures were modified to ensure ADS’ functionality.
How was it done?
Since Pharmacy department of CGH was the first to install an ADS, a new route had to be inaugurated, concerning how HPs:
• Developed the proposal
• Documented and justified such a supply to be prioritised in funding
• Performed market research in Europe, as no such national market existed
• Drafted technical specifications, to assure the best system supplied
• Participated in an international tendering procedure (budget 130,000 euros)
• Planned and supervised installation and functional integration of the system
• Managed interoperability between ADS’ software and the pharmacy’s Information System
• Faced issues related to different barcodes on medicines’ packages
What has been achieved?
After 3 months of use:
• 50% of medicines’ codes and 35% of total packages are dispensed with ADS monthly
• 1.4 full-time pharmacy assistants equivalent is saved
• Response time to requests decreased
• Traceability and quality are better assured
• Falsified medicines’ check can run automatically
• Storage space is saved
What next?
HPs are ready to share nationally and internationally their experience in developing and installing an ADS with colleagues interested in adopting similar solutions. Hospitals from the same region have already shown their interest.
Early-stage experiences of the implementation of a large-scale robotic storage and distribution system in a hospital pharmacy service within a large UK health authority
Pdf
European Statement
Selection, Procurement and Distribution