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Operational efficiency improvements for pharmacy workflow processes were evaluated using a barcode-enabled and integrated medication-tracking system for medications dispensed from the pharmacy to the emergency department (ED).The preimplementation study period (Period 1) was defined as November 17–December 16, 2015; system implementation and training, were defined as December 17, 2015–January 18, 2016; and postimplementation (Period 2) was defined as January 19–February 17, 2016. Periods 1 and 2 were compared to (1) quantify the number and type of phone calls received related to medication inquiries, (2) evaluate the percentage of redispensed doses per total dispensed doses, and (3) assess the rate of medication administration record (MAR) messages received per total dispensed doses.A reduction in the total number of phone calls by 77% was observed (from 125 to 29 calls). A 0.7% difference was detected for re-dispensed doses as well as MAR messages (0.009% difference in rate) between the 2 study periods. This difference was observed despite an increase in the total amount of dispensed doses that occurred for both redispensed doses (936) and MAR messages (920) during Period 2.A barcode-enabled and integrated medication-tracking system was successfully implemented into the medication distribution process in the ED. The process change increased operational pharmacy efficiencies by decreasing medication status phone calls, redispensed doses, and MAR messages.