Qualitative analysis to explore the barriers and facilitators around the implementation of automated dispensing cabinets at a large NHS Trust in England

Background

Automated dispensing cabinets (ADCs) as a tool to store and manage medication are becoming more widely used in healthcare settings. Although there is literature surrounding their effectiveness at reducing medication error and time for nursing and pharmacy staff, there is little information on how to implement ADCs on a large scale in a busy working clinical environment. The purpose of this study was to qualitatively determine the enablers and barriers to the implementation of ADCs in a hospital setting.

Methods

Participants were selected through purposeful sampling and invited to attend online focus groups and interviews via Microsoft Teams. These were recorded and transcribed. Two facilitators independently reviewed the transcriptions, coded and developed themes using Nvivo.

Results

There were 18 participants that took part in four focus groups and three interviews. These participants were from the pharmacy department, nursing, estates and the external porter company used for medication and supply. Nine themes and 31 sub-themes were identified from the data. The nine themes were; overall thoughts, strategy of implementation, stakeholder engagement, training, workflow changes, environment, evaluation, challenges and solutions to challenges.

Conclusion

This study has provided new insight into the required elements for implementing a large scale piece of new technology into a hospital setting. The data complemented other studies such as the challenges with staff training and the importance of ongoing optimisation of the ADCs post implementation. Key recommendations for others looking to implement ADCs include utilising videos and written materials for training early on and including nursing staff in the core project implementation team as well introducing mock cabinets for staff to practice on.