Background: Medication administration in residential aged care (RAC) is a high-risk process, with missed or delayed doses often arising from workflow interruptions and reliance on individual vigilance. Digital dose administration systems may improve efficiency and medication safety, yet real world evidence remains limited. This work contributes to the ageing revolution by demonstrating how digital medication systems can enhance efficiency, safety and workforce capacity in RAC. Methods: A pragmatic pre‑post study was embedded within routine care at a single RAC home. Medication administration was assessed using time and motion observations and device generated medication logs. Efficiency outcomes included medication round duration, workload adjusted time per administration event, and system modelling. Medication safety was assessed using missed administrations, and adherence using an administration derived Proportion of Days Covered. Results: Twenty-two medication rounds were observed pre implementation and seventeen rounds post implementation. Median round duration decreased from 76.5minutes to 62.0minutes. When adjusted for workload, estimated time per administration event decreased from approximately 4.1 to 2.4minutes. System modelling of 20,538 administration events across 673 rounds estimated a reduction in facility wide medication administration time from 151.0 to 88.4minutes, equating to approximately 703hours of facility-level capacity released over 62days. Missed administrations occurred in 12.5% of eligible opportunities at baseline. Administration based adherence increased from 86.0% to 91.4%. Conclusion: Implementation of a digital medication dose administration system was associated with improved efficiency, fewer missed medication administrations, and higher administration-based adherence in RAC. The findings offer insights for providers and policymakers considering digital solutions to improve medication safety while addressing workforce constraints.