The time required for pharmacy to deliver medications to the nursing unit under centralized and decentralized unit dose drug distribution (without satellites) systems was compared. Routing slips were attached to physicians' drug orders generated at a surgical nursing unit. Under the centralized system, the ward clerk sent the order to the pharmacy via pneumatic tube; the pharmacist received the order, transcribed it, and prepared the medication; and supportive personnel delivered the drug to the nursing station. The time required to perform each step was recorded on the routing slip for a five-week period. Under the decentralized system, the ward clerk placed the physicians' orders in the pharmacy box on the nursing unit. The pharmacist picked up the orders, filled them from a decentralized master medication cart, and placed the drug in the nurses' medication cart. Time required to complete the medication process was significantly less under the decentralized system than under the centralized system (54.15 +/- 42.82 versus 83.80 +/- 48.16; p less than 0.05).