Medication and consumable returns are a persistent operational challenge in hospitals, contributing to inventory inefficiencies, increased workload, and avoidable costs. To address these issues, the orthopaedic department of a tertiary care hospital implemented an Automated Medication Dispensing System (AMDS) to improve medication inventory management and optimize dispensing processes. However, the effect of AMDS on medication and consumable dispensing and return patterns had not been systematically evaluated. Consequently, evidence was needed to determine whether AMDS implementation improved operational efficiency and reduced unnecessary medication and consumable returns.
“Before-and-After Evaluation of Automated Medication Dispensing”
Author Affiliations
- World Health Organization. Medication Without Harm: WHO Global Patient Safety Challenge. Geneva: World Health Organization; 2017.
- Zheng WY, Lichtner V, Van Dort BA, Baysari MT. The impact of introducing automated dispensing cabinets, barcode medication administration, and closed-loop electronic medication management systems on work processes and safety of controlled medications in hospitals: a systematic review. Res Social Adm Pharm. 2020;17(5):832–841. doi:10.1016/j.sapharm.2020.08.001.
- Häninnen K, Ahtiainen HK, Suvikas-Peltonen EM, Tötterman AM. Automated unit dose dispensing systems producing individually packaged and labelled drugs for inpatients: a systematic review. Eur J Hosp Pharm. 2023;30(3):127–135. doi:10.1136/ejhpharm-2021-003002.
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Study Details
Published
Sep 2026
Category
Quality Excellence
Case Study ID
NABH-CS-2026-5219
Initiative
Objectives
Objectives
- To compare the total number of medication and consumable items dispensed during the pre- and post-implementation periods.
- To compare the total number of medication and consumable items returned during the pre- and post-implementation periods.
- To determine the percentage reduction in medication and consumable returns following AMDS implementation.
Methodology
Methodology
Study Design: Hospital-based retrospective before-and-after quality improvement study.
Study Setting: Orthopaedic department of a tertiary care hospital, Bengaluru, Karnataka, India.
Study Period:
- Pre-implementation: March–June 14, 2026
- Post-implementation: June 15–July 11, 2026
Data Source: Aggregate administrative data obtained from the hospital information system, including pharmacy return records.
Results and Impact
Following AMDS implementation, the transaction-based return rate decreased from 10.03% to 6.12% (38.98% relative reduction), and the value-based return rate declined from 7.05% to 4.32% (38.72% relative reduction). Return transactions dropped from 10,390 to 2,344. The interrupted time-series analysis confirmed a significant immediate level reduction of 3.42 percentage points (p=0.043) and a continued downward slope of -0.085 percentage points per day (p=0.038). Additionally, 73% of post-AMDS returns were processed through the AMDS cabinet.
Challenges & Critical Success Factors
As this is a short-term evaluation within an ongoing implementation project, the post-AMDS observation period was limited to 28 days. Findings may not be fully generalizable without further multi-specialty validation.
Key Learnings
With AMDS, point-of-care dispensing and efficient return routing have streamlined this process, thereby reducing nurses’ workload and freeing up valuable time for direct patient care activities.
This shift also contributes to enhanced quality of services by minimizing medication-handling errors and improving inventory accuracy at the ward level.
Fewer returns and better inventory management are expected to support smoother discharge processes.
Early findings suggest that AMDS not only optimizes pharmacy operations but also delivers downstream benefits to frontline nursing staff and overall patient flow.
By reducing unnecessary returns, the system supports more efficient resource utilization and cost containment — key priorities in a busy tertiary care setting.