OBJECTIVES: Implementation of automated dispensing cabinet (ADC) technology in hospitals has shown to improve clinical, operational, and economic outcomes. Safety and professional organizations recommend the adoption of ADCs in outpatient care areas, such as Ambulatory Surgical Centers (ASCs) and perioperative settings outside of the hospital. However, implementation of this technology in these settings has lagged significantly. The objective of this study was to assess the documented impact of ADCs in ASCs and perioperative care areas.

METHODS: A systematic literature review (SLR) was conducted in PubMed and Google Scholar in November 2022. The SLR was performed according to the PRISMA guidelines. Original research studies were included if they reported empirical data on ADCs in ASCs and perioperative areas. The search criteria consisted of site locations in North America or Europe, with articles written in English and published in the last thirty years. Outcomes were categorized as medication errors, drug diversion, inventory management, workforce satisfaction, and economic impact.

RESULTS: A total of eleven studies met the inclusion criteria. Six studies assessed ADC impact on drug diversion and controlled substance inventory management, with all studies finding reductions in missing controlled substances. Three studies showed a reduction in medication errors up to 100% after ADC implementation. Three studies revealed a positive impact on workforce satisfaction, with a range varying from 81%-100% of nurses across these settings being satisfied with ADC usage. Two studies showed post-ADC implementation labor cost savings.

CONCLUSIONS: ADC implementation in ASCs and perioperative care was found to decrease medication errors, reduce drug diversion/missing controlled substances, improve inventory management, increase workforce satisfaction, and reduce labor hours. Despite the current evidence, the literature assessed did not indicate conclusive evidence for the lag in adoption. Larger-scale studies are needed to support these findings, which would allow a stronger understanding of the multifactorial impact of ADCs in these settings.