Narrative Comparison of Hospital Pharmacy Practice Between Three Canadian Provinces

Charles Au, Cindy San, Sara Ingram


In Canada, pharmacists share similar entry-to-practice requirements and professional obligations.  However, since the administration of health care services is a provincial responsibility, pharmacy practice in the hospital setting may vary significantly across these systems.  The objective of this manuscript is to provide a broad overview of the differences in hospital pharmacy practice between Canadian provinces.  Differences in health care system organization, legislation and regulation, technology, drug reimbursement, and education are described, by highlighting examples from Alberta, British Columbia, and Ontario and discussing their impact on hospital pharmacy practice.  Pharmacists and student pharmacists across Canada are encouraged to appreciate the influence of systemic factors upon their practice and to collaborate on an interprovincial level to advance Canadian pharmacy practice.




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hospital; pharmacy; pharmacist; practice; province; territory; Canada; comparison; differences; description; British Columbia; Alberta; Ontario; scope; education


Health Human Resources. Pharmacists in Canada, 2010 [Online]. Canadian Institute of Health Information 2010 [cited 2012 Oct 18]. Available from: URL:

Hospital Pharmacy in Canada Editorial Board. Hospital Pharmacy in Canada 2009/2010 report [Online]. Hospital Pharmacy in Canada 2010 [cited 2012 Sep 28]. Available from:

Law MR, Ma T, Fisher J, Sketris IS. Independent pharmacist prescribing in Canada. Can Phar J.2012;145(1):17–23.

Blueprints for Pharmacy National Coordinating Office. Cross-jurisdictional scan of legislative and policy framework [Online]. Canadian Pharmacists Association 2012 [cited 2012 Oct 1]. Available from: URL:

Wilby KJ, Kitutu FE, Boakye S. Practice spotlight: volunteer pharmacists in sub-saharan Africa. Can J Hosp Pharm.2012 May;65(3):229–30.

Meek W. Pharmacists volunteering in Tanzania. Can Phar J.2009 May;142(3):118.

Hogan K. Integrating international pharmacy graduates into the workforce. Can Phar J.2008;141(4):252.

Moving Forward: Pharmacy Human Resources for the Future. Integration of international pharmacy graduates into the Canadian pharmacy workforce: barriers and facilitators, final report [Online]. Canadian Pharmacists Association 2008 [cited 2012 Sep 30]. Available from: URL:


Simpson SH. Of silos and systems: the issue of regionalizing health care. Can J Hosp Pharm.2011;64(4):237.

Hurley J. Regionalization and the allocation of healthcare resources to meet population health needs. HealthcarePapers 2004;5(1):34–9.

Church J, Barker P. Regionalization of health services in Canada: a critical perspective. Int J Health Serv.1998;28(3):467–86.

AHS gives regional zones more authority[Online]. CBC News 2011 May 3 [cited 2013 Jan 6]. Available from:URL:

Hospital Employee’s Union. Transfer of Lower Mainland pharmacy services to Fraser Health planned for spring [Online].HEU Newsletter 2011 Sep 28 [cited 2013 Jan 6]. Available from: URL:

British Columbia health authorities [Online].British Columbia Ministry of Health Services 2011[cited 2013 Jan 6].Available from:URL:

Lower Mainland consolidation project. Due diligence assessment, final report[Online]. British Columbia Ministry of Health Services 2010 Jul 26[cited 2013 Jan 6]. Available from:URL:

Moloughney B. A discussion paper on public health, Local Health Integration Networks, and regional health authorities [Online]. Ontario Public Health Association 2007 [cited 2012 Sep 30].Available from:URL:

Slobodan J, van Haaften D, Chambers CR. Is a single provincial pharmacy program beneficial for the advancement of pharmacy practice? Can J Hosp Pharm.2011 Jul;64(4):285–7.

Charrois T, Rosenthal M, Tsuyuki RT. Stories from the trenches: experiences of Alberta pharmacists in obtaining additional prescribing authority. Can Phar J.2012 Jan;145(1):30-4.

Pearson GJ. Evolution in the practice of pharmacy–not a revolution! Can Med Assoc J.2007 Apr 24;176(9):1295–6.

Yuksel N, Eberhart G, Bungard TJ. Prescribing by pharmacists in Alberta. Am J Health Syst Pharm.2008 Nov 15;65(22):2126–32.

Blueprint for Pharmacy National Coordinating Office. British Columbia –Key legislation and policy dates [Online]. Canadian Pharmacists Association 2011 [cited 2013 Jan 6]. Available from: URL:

Expanded scope of practice [Online]. Ontario College of Pharmacists 2012 [cited 2013 Jan 6]. Available from: URL:

Bacovsky RA. Pharmacist prescribing: has the momentum started? Can J Hosp Pharm.2012 Nov;65(6):421–2.

Chant C. “Partners in crime”: pharmacists and pharmacy technicians. Can J Hosp Pharm.2010 Sep;63(5):353–4.

Mabasa VH, Malyuk DL, Tung A, Balen RM, Nicolls TR, Rahiman NL. Using clinical pharmacy support technicians to optimize pharmaceutical care in the intensive care unit. Can J Hosp Pharm.2010 Jan;63(1):41–5.

Johnston R, Saulnier L, Gould O. Best possible medication history in the emergency department: comparing pharmacy technicians and pharmacists. Can J Hosp Pharm.2010 Sep;63(5):359–65.

Remtulla S, Brown G, Frighetto L. Best possible medication history by a pharmacy technician at a tertiary care hospital. Can J Hosp Pharm.2009 Sep;62(5):402–5.

Priest L, Howlett K. Breast-cancer patient gets access to costly treatment [Online]. The Globe and Mail 2011 May 11 [cited 2012 Sep 23]. Available from:


MacGregor L. The promise of Herceptin [Online]. CBC News 2011 Mar 21 [cited 2012 Sep 23]. Available from: URL:

Yoong D. Access and coverage of antiretroviral drugs across Canada [Online]. Immunodeficiency Clinic 2012 Aug [cited 2013 Jan 6]. Available from: URL:

CHPRB accredited programs [Online]. Canadian Society of Hospital Pharmacists 2013 [cited 2013 Jan 6]. Available from: URL:

D’Adamo M, Kols A. A tool for sharing internal best practices [Online]. The INFO Project 2005 [cited2012 Sep 29]. Available from: URL:

Canadian Patient Safety Institute. Communities of Practice: Background [Online]. Canadian Patient Safety Institute 2010 [cited 2012 Sep30]. Available from: RL:

CSHP 2015 –frequently asked questions [Online]. Canadian Society of Hospital Pharmacists 2012 [cited 2012 Aug 20]. Available from: URL:

Blueprint for Pharmacy National Coordinating Office. Blueprint for Pharmacy –About [Online]. Canadian Pharmacists Association 2012 [cited 2012 Sep 30]. Available from: RL: