A pragmatic pre-post evaluation at a 130-bed residential aged care facility. Time-and-motion observation, device-generated logs, and staff surveys — conducted independently by La Trobe University.
Dr Tshepo M. Rasekaba & Prof. Hanan Khalil
John Richards Centre for Rural Ageing Research
Median round duration decreased from 76.5 minutes pre-SASHA to 62 minutes during the SASHA era — a reduction of 14.5 minutes per round. Dispersion also tightened, with fewer extremely long rounds observed.
In a 130-bed facility conducting three to four rounds per day, a sustained fifteen-minute saving per round reclaims approximately five to seven hours of nursing time per week.
Down from 76.5 minutes at baseline
When adjusted for workload, the improvement was even more pronounced. The estimated number of medication events per round increased from 18.8 pre-SASHA to 26.2 during implementation — a higher throughput.
Despite handling more medications per round, time per administration event decreased from 4.07 minutes to 2.37 minutes. Staff were doing more work in less time.
Down from 4.1 minutes — while handling 39% more events per round
Using mechanistic modelling from SASHA device logs, the evaluation estimated facility-wide medication administration duration across all units.
Median facility-span duration decreased from 151 minutes pre-SASHA to 88.35 minutes during the SASHA era — a median reduction of 62.65 minutes per facility-wide round.
Applied to the 673 observed rounds, this represents a total facility-level time saving of 42,159 minutes (702.7 hours). Using an 8-hour shift equivalent, this represents approximately 87.8 full facility-shift hours reclaimed over 62 days.
88 full facility shifts reclaimed over 62 days. System-level capacity gain — not additive staff labour.
During the pre-SASHA period, medication administration was successfully completed in approximately 86% of observed rounds, with missed or refused doses commonly attributed to resident unavailability, refusal, workflow interruptions, or competing care demands.
Following SASHA implementation, round-level medication coverage increased to 91.4% — a 5.4 percentage-point absolute improvement.
Baseline missed administrations: 12.5% of observed opportunities
Staff commonly reported improved medication accuracy, reduced risk of administration errors, decreased manual handling, and less physical strain from eliminating the trolley.
Device reliability was a prominent concern. Common issues included unstable Wi-Fi, fingerprint scanning failures, sachet jams, and time required to reload cartridges.
Staff described difficulty balancing medication administration with personal care duties. Role ambiguity reduced focus and efficiency, particularly among personal care workers.
Training needs were commonly identified. Staff highlighted the importance of ongoing education, regular competency checks, and practical troubleshooting skills.
The implementation of SASHA was associated with improved medication administration efficiency, enhanced adherence, and strengthened system-level medication safety in a residential aged care facility.
The findings indicate that digital dose administration aids can release meaningful clinical capacity and support safer medication practices without increasing staffing, provided that technical performance, workflow integration, and staff training are adequately addressed.
Staff acceptance was high but conditional. Acceptance reflected the extent to which the system was reliably integrated into existing workflows — rather than any fundamental concern with the model itself.