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In an effort to reduce waste and save staff time, hospitals have increasingly turned to automation technology to manage pharmacy inventory. In fact, automated dispensing cabinets are now so common — used by over 90% of hospitals — that the question is no longer whether to adopt them but how to maximize their benefits.1 When used effectively, those potential benefits include avoiding medication errors, saving nurses’ time, reducing drug diversion, and more.1-4

Crash carts are a notable exception in the trend toward automated inventory management. Thanks in part to a cart design that has changed remarkably little in decades, the entire emergency preparedness process — from checking crash carts before a resuscitation event to restocking them after — is still handled manually at many hospitals.

So what do hospitals stand to gain by bringing crash cart inventory management under the automation umbrella? Keep reading to find out.

Why automate crash carts?

In short: to reduce risk. Not only are pen-and-paper cart checks and manual restocking processes tedious and repetitive, but errors can directly affect patient safety in an emergency.

In a 2017 publication, The Joint Commission noted that many crash carts have “hidden issues” that could adversely affect patient safety.5 Medication errors and mix-ups, missing or damaged equipment, drained batteries, and carts not inspected properly can all delay treatment when there’s no time to spare.5

The bottom line: There are any number of complex clinical variables that can affect the outcome of an emergency resuscitation event. But an error or delay stemming from inadequate crash cart readiness is preventable and shouldn’t be one of them. Unfortunately, current manual processes make it difficult for staff to avoid these kinds of errors.

Let’s look at 4 areas where manual crash cart inventory management falls short — and how automation can help hospitals reduce risk.

1. Inventory management


  • Right-size crash cart inventory: Managing inventory is a balancing act anywhere in the hospital, and crash carts are no exception. Stock too little, and you risk running out of drugs and supplies needed during an emergency resuscitation event. Stock too much, and you increase the burden on staff members to manage, organize, and sift through the excess supply.
  • Easily identify expired drugs: Staying on top of expiring medications helps hospitals prevent waste and protect patients at the same time, but it’s more challenging with a manual system in place.


Automated systems take the guesswork out of the inventory equation by tracking actual usage and providing awareness of crash cart contents at all times.

  • Automated expiration alerts save staff time and reduce the likelihood that an expired drug is inadvertently administered to a patient.
  • In the event of a product recall or a change to standards of care, staff can easily search inventory across carts and identify items that need to be replaced.

2. Emergency resuscitation readiness


  • Standardize crash cart organization: It’s not just about convenience and general orderliness. If you can avoid unnecessary variations in storage and organization from cart to cart, response teams are far more likely to find the resources they need. In an emergency event, this can mean the difference between a timely response or a costly delay in patient care.
  • Improve oversight of cart checks: No response team should have to contend with missing crash cart supplies or malfunctioning equipment in the middle of a life-threatening emergency. Cart checks help prevent that from happening, and it’s why The Joint Commission requires hospitals to have a written plan specifying how frequently they occur.6 But establishing protocols is one thing; ensuring they’re carried out is another.


Automated systems help hospitals define (and stick to) standardized templates for crash cart contents and organization. For cart checks, automatic reminders and tracking & reporting increase confidence that checks are happening per hospital policy.

3. Time savings


  • Reduce staff time spent on manual tasks without sacrificing emergency resuscitation preparedness. Less time spent on inventory translates to more time with patients.
  • Respond rapidly during a cardiac arrest to maximize the patient’s likelihood of survival.


  1. Save staff time traditionally spent filling out pen-and-paper checklists, managing inventory, and checking for expired products.
  2. Avoid delays during a resuscitation event by ensuring that crash carts are checked and stocked with the resources needed.

4. Security and compliance


  • Balance crash cart security with ease of use6: Cart security measures are necessary to reduce drug diversion and tampering. But introducing too many barriers can cost response teams valuable time in an emergency. All hospitals have to balance these considerations when it comes to crash carts.
  • Ensure drug tracing and accountability: Accurate tracking of drugs and lot numbers is essential to managing product recalls. But drugs that are stored and managed manually on crash carts don’t link to the hospital’s electronic systems and are harder to keep track of. This is also why hospitals may struggle with drug reconciliation after an emergency resuscitation event, increasing the likelihood of inaccurate charges.


Hospitals can monitor access to carts electronically and create an audit trail of who opened cart drawers and when — all without reducing accessibility in an emergency. Automated systems also make it easier to track administration of crash cart medications to the patient, improving billing accuracy and enabling hospitals to easily identify patients affected by a recall.


Crash cart automation technology is here

Manual crash cart processes take up valuable staff time and may leave hospitals vulnerable to gaps in emergency care readiness. See how the EMMIT® Emergency Care System can help.


  1. Automated dispensing cabinets. State of Pharmacy Automation. 2019;16(8): 50.
  2. American Society of Health-Systems Pharmacists. ASHP guidelines on the safe use of automated dispensing devices. Am J Health-Syst Pharm. 2010;67:483-90.
  3. Cottney A. Improving the safety and efficiency of nurse medication rounds through the introduction of an automated dispensing cabinet. BMJ Qual Improv Rep. 2014 Apr 25;3(1).
  4. Zheng WY, Lichtner V, Van Dort BA, et al. 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. Research in Social and Administrative Pharmacy. 2021 May;17:832-841.
  5. The Joint Commission. Crash-cart preparedness. Quick Safety. 2017 Apr;32:1-3.
  6. The Joint Commission. What’s your question? What’s your solution? EC News. 2021 July; 24(7):19-22.
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