Objectives & Background Compliance with UK pharmacy standards requires medications to be stored in a locked cupboard. This creates inefficiency in a busy emergency department (ED) as there are delays locating the keys, then finding the medications in the cupboard. We report the efficiency gains of an Omnicell cabinet which is accessed by staff fingerprint and has a system of guiding lights to identify the requested medication within the cabinet. This is a prospective observational study comparing the time from prescription to administration of medications before and after the installation of an Omnicell.

Methods The study setting was a tertiary academic centre in England with 130,000 attendances per annum. Prior to the installation of the Omnicell, we measured the time taken in minutes (min) for the nurse to locate the keys to the drug cupboard. We also measured the dispensing time. This was measured as the time from when the nurse reads the prescription of an oral medication to when the tablets were physically obtained by the nurse. A research nurse not involved in the care of the patient measured the dispensing time for a convenience sample of 100 patients over a four week period. A second convenience sample was collected 6 months after the installation of the cabinet. Participants were unaware of the study outcomes.

Results The mean time to locate the keys prior to the implementation of the Omnicell was 2.4 min (sd 2.7 min, n=110). The mean time taken to dispense medication prior to implementation was 7.5 min (sd 13 min, n=110) and after implementation was 1.1 min (sd 0.7 min, n=107). The mean time difference was 6.4 min (idependent t-test, 95% CI 3.9 to 8.9 min).

Conclusion This is the first study in a UK civilian ED to quantify the efficiency gains of the implementation of an Omnicell cabinet. We demonstrated that there was a time saving by removing the need to locate keys for the medication but this was only an average of 2.4 min. We underestimated the time saving that was made by having a system of guiding lights which directed the user to the correct medication within the cabinet. This contributed to the overall time saving of 6.4 min for every medication prescribed. This represents a significant improvement in efficiency in a large busy ED with more than three hundred attendences a day.