Resource Spotlight: Green Practices in Hospital Pharmacy

May 7, 2024
Written by Huy Pham
This article was written and researched by a CSHP student member for Interactions, our biweekly newsletter. Crafting these pieces not only helps students gain in-depth knowledge of specific conditions, treatments, and resources, it also helps them hone their skills in research, critical appraisal, evaluation, synthesis, and writing – all of which will serve them well in clinical practice. The Professional Practice Team works with the student to select topics that are of interest and utility to both the student and to you, the reader. We hope you enjoy this piece by one of our future colleagues! Let us know what you think: If you would like to provide any comments or constructive feedback for our students, please email us at


There are numerous environmental impacts from the use of pharmaceuticals throughout their life cycles. These can manifest from the greenhouse emissions associated with pharmaceuticals, from the ecological effects of pharmaceuticals in the environment, or from the impact of plastic waste from pharmaceutical packaging. However, there are green procurement strategies that can be implemented to reduce the environmental impact of the Canadian drug supply chain.

This “Resource Spotlight” contains links to tools and resources to help pharmacists learn more about environmental sustainability and green procurement and to aid in the implementation of sustainability initiatives, as well as provide examples of green initiatives that have been implemented. To learn more about the environmental impact of pharmaceuticals and sustainable procurement of pharmaceuticals, check out CSHP’s recent Clinical Pearls article on green supply chains in hospital pharmacy.


Canadian Resorces

Creating A Sustainable Canadian Health System In A Climate Crisis (CASCADES)
CASCADES is a pan-Canadian coalition that is dedicated to support the transition of the Canadian healthcare community system towards environmental sustainability and climate resilience. Their website contains a step-by-step guide to creating a practice of pharmacy that is climate resilient and low carbon sustainable. The CSHP Sustainability Task Force was involved with the review of the playbook. In addition, CASCADES has a playbook that aims to address the issue of environmental sustainability in organizational readiness, with an activity matrix to help identify opportunities for the implementation of sustainability.

Choosing Wisely Canada
The recommendations by Choosing Wisely Canada can reduce the amount of unnecessary treatments, which not only prevent undue harm to the patient as a result of unnecessary treatments but also reduces overall production of waste. There are recommendations drafted by CSHP specific to the hospital pharmacy setting as well as patient resources to enable conversations about their medications. In addition, Choosing Wisely had a webinar on the environmental co-benefits of reducing overuse and low-value care.

Plus, on May 15, CSHP will be joining Choosing Wisely Canada's talks to introduce CSHP and CPhA's brand new joint recommendations, offering practical ways to stop or reduce routine pharmacy practices that harm the environment without compromising patient care alongside the likes of Dr. Srinivas Murthy and Dr. Marko Balan from the Canadian Critical Care Society and many more. You can learn more about this event here and register here

Canadian Association of Pharmacy for the Environment (CAPhE)
CAPhE is a volunteer-run organization of pharmacy professionals who aims to improve and promote planetary health in the pharmacy profession. Their “Planetary Health & Pharmacy” webpage outlines topics such as pharmacy's contribution to pollution, disaster planning, and medication management during heat waves. They have a dedicated QID community for the exchange of best practices for climate change management and for encouraging the creation of committees to address environmental issues.

Canadian Coalition for Green Health Care
Canadian Coalition for Green Health Care is a green health care resource network that strives to create a net zero, climate resilient, environmentally sustainable health system by enabling the development of green policies and practices in healthcare. They have a free monthly Green Health Care Digest that outlines initiatives in green health care, upcoming events, and updates on Coalition activities. There is also an Environmental Stewardship Guidebook for hospitals that serves as a primer to facilitate the transition towards an overall greener structure. The Coalition, in partnership with the Children’s Hospital of Eastern Ontario (CHEO), drafted a Green Hospital Procurement Guide to aid health care institutions and organizations with implementing policies and procedures on environmentally preferable purchasing. A webinar hosted by Canadian Coalition for Green Health Care, PEACH Health Ontario, and CASCADES covers the issue of pharmaceuticals in the environment, how they enter the environment, and their impacts on wildlife.

Partnerships for Environmental Action by Clinicians and Communities for Hospitals / Health care facilities (PEACH)
PEACH is an Ontario initiative for the engagement, encouragement, and empowerment of individuals in the health care sector to create climate action at their facilities. The website acts as a hub for the information sharing on new initiatives and a platform for project collaboration. They have infographics and resources on topics including sustainable prescribing, the safe elimination of certain products and packaging, and creating a hospital green team.

Canadian Agency for Drugs and Technologies in Health (CADTH)
CADTH has published a Horizon Scanning report on the environmental impact of clinical care. The report outlines the principles and concepts behind environmentally sustainable health care and gives examples of initiatives and activities in sustainable clinical care such as inhaler prescribing and opportunities in procurement.

International Resources

Health Care Without Harm (HCWH)
HCWH is an international nongovernmental organization that works to reduce the environmental footprint of health care worldwide and lead a global movement for environmental health and justice. The U.S. and Canada branch has sample policies for hospitals to help facilitate environmental preferable purchasing. The website also has a dedicated page for waste management, describing strategies for waste management and the principles for sustainable health care waste management. 

Global Green and Healthy Hospitals (GGHH) 
GGHH is an international network of over 1,750 hospitals, health care facilities, health systems, and health organizations from more than 80 countries that strives to reduce the environmental impact of hospital care and promote environmental and public health. Their Sustainable Procurement Guide provides guidance on creating and advocating for sustainable purchasing strategies with examples of healthcare organizations worldwide.

National Health Service
The NHS has released a report on their ambitions towards net zero. This report outlines the specific interventions that the NHS has undertaken to reduce the carbon footprint of the NHS, as well as their proposition for new, sustainable models of care. The NHS has a monthly bulletin that provides updates on their efforts toward net zero and ways to be involved with the NHS's push towards sustainable care.

JanusInfo Pharmaceutical and Environment
JanusInfo is a Swedish drug information website developed by the Stockholm Region Pharmaceutical Committee. They have a database that classifies pharmaceuticals based on their environmental hazard and risk. Each drug in the database has a profile that describes their capacity for bioaccumulation, environmental persistence in aquatic environments, and toxicology to aquatic organisms.