Hospitals and other institutions and facilities, such as outpatient clinics, drug-dependency treatment facilities, poison control centres, drug information centres, and long-term care facilities, may be operated by the government or privately. While many of the pharmacist’s activities in such facilities may be similar to those performed by community pharmacists, they differ in a number of ways. Additionally, the hospital or institutional pharmacist:

• has more opportunity to interact closely with the prescriber and, therefore, to promote the rational prescribing and use of drugs;

• in larger hospital and institutional pharmacies, is usually one of several pharmacists, and thus has a greater opportunity to interact with others, to specialize and to gain greater expertise;

• having access to medical records, is in a position to influence the selection of drugs and dosage regimens, to monitor patient compliance and therapeutic response to drugs, and to recognize and report adverse drug reactions;

• can more easily than the community pharmacist assess and monitor patterns of drug usage and thus recommend changes where necessary;

• serves as a member of policy-making committees, including those concerned with drug selection, the use of antibiotics, and hospital infections (Drug and Therapeutics Committee) and thereby influences the preparation and composition of an essential-drug list or formulary;

• is in a better position to educate other health professionals about the rational use of drugs;

• more easily participates in studies to determine the beneficial or adverse effects of drugs, and is involved in the analysis of drugs in body fluids;

• can control hospital manufacture and procurement of drugs to ensure the supply of high-quality products;

• takes part in the planning and implementation of clinical trials.