Optimising operational efficiency in Automated Dispensing Cabinets

Aim

To ensure the successful pilot of a remote queue and waste component within a statewide Automated Dispensing Cabinet (ADC) solution as part of an overarching roll-out to a sub-acute facility within a tertiary hospital.

Outcomes

• The use of a remote queue and waste component within the statewide implementation of  ADCs has reduced congestion in medication rooms
• The pilot of Becton Dickinson’s (BD) Pyxis Medlink Queue & Waste2 at Gold Coast Hospital and Health Service (GCHHS) was made possible through an uplift of the Statewide Automated Dispensing Cabinet Service  (SWADCS) support model
• A collaborative effort between the hospital and health service (HHS), vendor and Digital Health Solutions (DHS) ensured timely delivery within the constraints of the overarching ADC rollout
• This successful pilot positions SWADCS  with the knowledge and experience to implement BD Pyxis Medlink Queue & Waste at other SWADCS sites.

Background

Gold Coast University Hospital undertook a major digital transformation between November  2024 and September 2025 to implement Automated Dispensing Cabinets (ADCs) across multiple clinical areas. ADCs had already been successfully deployed at Tugun Hospital, demonstrating the value of digital medication management within Gold Coast Health. The  expansion into the newly opened H Block, home to sub acute geriatric wards, represented a significant next phase of the hospital wide rollout. Sub acute geriatric care requires reliable, timely access to medications to support complex patient needs, yet traditional  medication rooms relied heavily on manual stock rotation, handwritten logs, and a reactive replenishment process.

These practices created inefficiencies, increased the risk of expired stock remaining in circulation, and placed administrative burden on nursing  and pharmacy teams. As the ADC program progressed into H Block, it became clear that further refinement of workflow processes was needed to address emerging workflow congestion concerns, particularly around physical queuing that was predicted to happen in  the medication rooms. BD Pyxis MedLink Queue and Waste was identified as a key solution to this problem, as it offered the ability to perform part of the nursing workflow remotely by queuing medication removals away from the device.

Discussion

The introduction of this feature during the final stages of the ADC rollout highlighted  the importance of flexibility, collaboration, and strong governance in digital health implementations. Close engagement between DHS, the HHS, and the vendor ensured that the solution was not only technically sound but also operationally appropriate for the  environment within H Block. This collaborative approach helped manage workflow considerations early and ensured that the feature enhanced, rather than disrupted, existing clinical routines. Aligning the new functionality with both local practice and statewide  support expectations was a key success factor.

By updating statewide documentation and ensuring support teams were trained and informed, the project strengthened long term sustainability and reduced the risk of knowledge gaps emerging after go live. This alignment  also ensured that the feature could be supported consistently across Queensland Health in future iterations of its implementation. This project also revealed several important lessons. While MedLink contributed to reducing congestion during nurse medication  rounds by improving task sequencing and reducing unnecessary cabinet interactions, it was not a complete solution to workflow bottlenecks.

Observation of the nursing workforce highlighted the importance of assessing nurse to ADC ratios, with a 16:1 ratio considered  ideal to minimise queuing and delays during peak medication round periods. This reinforced that digital tools must be paired with thoughtful operational design to achieve meaningful improvements. The nuances of the ADC system further emphasised the need for  expert knowledge. Understanding how the device workflow fits within the broader ward workflow proved essential for streamlining the entire medication management process. Subtle configuration choices, cabinet layout decisions, and user interaction patterns  all influenced efficiency, underscoring the value of experienced digital health staff in guiding optimisation.

The outcomes of this implementation also provide valuable insight for prospective SWADCS sites, particularly those where physical space or the number  of devices is limited. MedLink’s ability to reduce congestion and streamline cabinet interactions offers a practical pathway for sites seeking to optimise workflows without expanding their physical footprint. Existing ADC sites may also benefit from adopting  similar approaches to improve efficiency while keeping costs manageable. Next steps involve gathering long term, quantitative data to compare workflows with and without MedLink, as current observations are largely anecdotal. Measuring the impact on congestion,  medication round duration, and staff experience will help validate the benefits and inform future optimisation across GCHHS and other Queensland Health sites.