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ADDITIonAL RESouRCES a ASHP sections are membership component groups that cover the following areas of hospital and health-system pharmacy practice: (1) management, (2) inpatient care, (3) ambulatory care, (4) clinical specialty practice, and (5) informatics and technology.

History is not concerned with predicting: the ability to predict would mean a closed and determined universe or, perhaps worse, a managed one. And if we know anything from our observation of the drama of history, it is that history is open, full of extraordinary potential and inexplicable turns and changes.-Page Smith (historian) The future has already arrived. It's just not evenly distributed yet.-William Gibson (science-fiction writer)

Key factors outside of health-system pharmacy that will shape this sector of the profession in the coming years are (1) the national economy, (2) national politics, (3) the debt of the federal government, (4) global megatrends (including terrorism and economic globalization), (5) health care reform, and (6) trends in the development and use of medicines. These factors will translate into payment cutbacks to hospitals, expanded mandates to improve the quality of health care, increased focus on patient-centered care, more team-based care, and a higher degree of integration across the range of health care settings and providers. In this environment, pharmacists in hospitals and other health systems will have rich opportunities to help improve patient care and institutional sustainability by continuing to move from order-fulfillment and product-preparation functions toward team leadership of drug therapy management. The American Society of Health-System Pharmacists Pharmacy Practice Model Initiative (PPMI) was created to encourage hospital and health-system practice leaders to examine how they deploy their resources (ie, pharmacist time, technician time, and technology) to ensure that the efforts of the pharmacy department are aligned with the most urgent needs of patients and institutions. Key recommendations of the PPMI and evidence about gaps in the provision of drug therapy management services are presented. It is important for every pharmacist and pharmacy technician in health-system practice to understand the imperatives for changing the profession's practice model and to actively pursue appropriate changes in that model.

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