EAHP represents over 30,000 hospital pharmacists across 37 member countries. EAHP represents and develops the hospital pharmacy profession within Europe in order to ensure the continuous improvement of care and outcomes for patients in the hospital setting. This is achieved through science, research, education, practice, as well as sharing best-practice and responsibility with other healthcare professional
The EAHP Board, elected for three-year terms, oversees the association’s activities. Comprising directors responsible for core functions, it meets regularly to implement strategic goals. Supported by EAHP staff, the Board controls finances, coordinates congress organization, and ensures compliance with statutes and codes of conduct.
The EAHP staff supports the Board in executing EAHP’s mission. The Staff assists in financial management, events organisations, policy activities and all EAHP projects. The EAHP staff works closely with EAHP’s members and ensures the effective communication all relevant stakeholders.
The first member countries were Belgium, Britain, Denmark, France, the Federal Republic, Germany, Italy and The Netherlands in 1972. EAHP has now 36 EAHP members and 2 Associate Members. EAHP is open to countries members of the Council of Europe and since 2022 to organisations representing the interests of hospital pharmacists from outside the Council of Europe (Associate Membership)
EAHP’s structure is also composed by different standing committes: EAHP Scientific Committee, EAHP Education Executive Committee and the EAHP CTF Steering Committee.
At EAHP, we are committed to transparency in our governance, ethical standards, and funding practices. This section provides open access to our foundational documents, including the EAHP Statutes, Code of Conduct, and Funding Sources. By sharing these resources, we aim to uphold accountability and foster trust with our members, partners, and the public.
Keep up with all EAHP’s events and webinars. Contact the team at info@eahp.eu should you have any questions about upcoming events or activities.
Here you can find all upcoming events organised by EAHP and by all its members and associate members. Do not hesitate to contact the events team at events@eahp.eu should you have any questions about the organisation of these events.
Hospital pharmacists conduct a critical role in the care of patients in hospitals. Learn more about what they do here and in all the pages under Hospital Pharmacy practice and Policy.
Self-Assessment
SILCC
Closed SIGs
EAHP brings together experts from many areas of hospital pharmacy practice providing and highlighting good local sustainable practices as that can be up-scaled and shared with other countries. The EAHP Working Group on Sustainability has the aim of reducing the environmental burden of the hospital pharmacy services.
The European Association of Hospital Pharmacists (EAHP), and its 36 member country platforms are creating a Common Training Framework for the hospital pharmacy education in Europe. The goal of this project is to allow the free movement of hospital pharmacists within the European Union.
The European Association of Hospital Pharmacists (EAHP) and the European Society of Clinical Pharmacy (ESCP) have collaboratively developed the Oath to Society. The Oath to Society is all encompassing and acts as a contract for excellence in providing compassionate patient care, working as part of the healthcare team and advancing the pharmacy profession, and showcasing how clinical and hospital pharmacists work every day
A day created to highlight the importance and to celebrate the work done by hospital pharmacies. This day celebrates all hospital pharmacy teams.
Catch up with EAHP’s press releases
Find all EAHP relevant publication like the EAHP Surveys, annual reports and the history books.
The European Journal of Hospital Pharmacy (EJHP) is the only official journal of the European Association of Hospital Pharmacists (EAHP) and is committed to advancing the science, practice and profession of hospital pharmacy. As the premier communication platform for hospital pharmacists worldwide, EJHP is a major source for continuing education as well as updates on advances in the practice and standard of pharmaceutical care for patients.
When EAHP and Hospital pharmacists appear in the news.
EAHP publishes a monthly EU monitor with updates about the latest EAHP initiatives and information relevant for the hospital pharmacy profession.
Sponsor Channel
The Sponsor Channel is designed to maximise visibility and engagement, allowing sponsors to connect with the hospital pharmacy community and partners in a dynamic and interactive environment. From product demonstrations to networking sessions, the Sponsor Channel offers a range of opportunities for sponsors to showcase their offerings and generate leads in the new EAHP Website.
Patient Safety and Quality Assurance
Elena Blanco Saiz
It is estimated that over 80% of patients receiving treatment with cetuximab experience acneiform eruptions and/or skin dryness and flaking. Approximately 15% of these cutaneous reactions are severe, including cases of skin necrosis.
These skin lesions may predispose patients to secondary infections, potentially leading to complications such as cellulitis, erysipelas, staphylococcal scalded skin syndrome, necrotizing fasciitis, or sepsis, which can result in death.
A kit consisting of an alcohol-free moisturizing cream, an alcohol-free gel, and a sunscreen with a sun protection factor of 100 was provided to patients undergoing treatment with cetuximab for daily skin care.
When the oncology department prescribes cetuximab, the patient is informed that a kit will soon be dispensed.
The pharmacy service reviews daily the patients who will initiate treatment with cetuximab in the day treatment center. If there is a patient starting treatment, nursing staff notify us when they arrive at the center, and the pharmacy dispenses a kit while explaining its contents.
We periodically call the patient to check whether they are continuing to use it correctly, if they have noticed any changes in their skin, what changes they have observed, and whether they have needed to take antibiotics and/or topical corticosteroids.
• To date, the kit has been dispensed to 21 patients undergoing treatment with cetuximab.
• It empowers patients by actively involving them in their care.
• It prioritizes the overall well-being of the patient, as it may prevent the onset of dermatological side effects and the use of topical corticosteroids and oral antibiotics.
• The process facilitates the pharmacist’s engagement with the patient in the day treatment center and throughout the treatment, allowing for addressing concerns, answering questions, and providing information about adverse effects.
• It promotes the creation of a multidisciplinary team by involving collaboration between oncology, nursing, and pharmacy.
We present a practical approach that enhances patient safety during the oncology process.
This practice can be adopted by any center.
It is necessary to continue collecting data to obtain reliable results regarding its impact on improving patient safety.
Education and Research
Damuzzo V (1), Rivano M (2), Cancanelli L (3), Brunoro R (4), Gasperoni L (5), Ossato A (6), Colicchio A (7), Del Bono L (8), Di Spazio L (9), Celentano Fasano CN (10), Chiumente M (11), Mengato D (12), Messori A (13)
1) UOC Farmacia, AULSS2, P.O. di Vittorio Veneto
2) Hospital Pharmacy, Azienda Ospedaliero Universitaria, Cagliari
3) UOC Farmacia, AULSS2 Marca Trevigiana, P.O. di Castelfranco
4) School of Specialisation in Hospital Pharmacy, University of Milan, Milan
5) Oncological Pharmacy, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori, Meldola;
6) School of Specialisation in Hospital Pharmacy, University of Padua, Padua
7) Hospital Pharmacy, Azienda Unica Sanitaria Locale di Bologna (AUSL), Bologna
8) Azienda Ospedaliera Universitaria Pisana, Pisa
9) Hospital Pharmacy, Santa Chiara Hospital, Trento, Azienda Provinciale per i Servizi Sanitari (APSS);
10) Hospital Pharmacy, Azienda Ulss 3 Serenissima, Mirano,
11) Italian Society of Clinical Pharmacy and Therapeutics (SIFaCT), Milan
12) Hospial Pharmacy Unit – Azienda Ospedale-Università Padova
13) HTA Unit, Tuscany Region, Florence
The clinical selection of available treatments and medical devices (MDs) is often hindered by the absence of direct efficacy comparisons between emerging therapies. This AI-tool aimed to address this challenge by employing advanced analytical techniques to facilitate informed decision-making in clinical settings.
In 2016, the Italian Society for Clinical Pharmacy and Therapeutics (SIFaCT) launched the AVVICINARE project with the goal of training young hospital pharmacists to develop innovation in research based on non-original, already published data. We recently approached the field of indirect comparisons, applying the artificial intelligence (AI) technique ‘IPDfromKM’ to extract individual patient data (IPD) from Kaplan-Meier (KM) survival curves, enabling the indirect comparison of emerging pharmacological treatments and MDs
Drugs and technologies with similar therapeutic roles and efficacy assessed by time-dependent endpoints (Overall Survival, Progression-Free Survival) were identified. KM curves from relevant clinical trials were digitized, and the IPDfromKM application was used to reconstruct the IPD. Data from different studies on the same treatments were pooled to enhance sample size, and standard statistical techniques (Cox regression, inter-treatment comparison) were employed, considering long-surviving patients (restricted mean survival time [RMST]). A heterogeneity analysis ensured comparability of patient cohorts.
Drugs and technologies with similar therapeutic roles and efficacy assessed by time-dependent endpoints (Overall Survival, Progression-Free Survival) were identified. KM curves from relevant clinical trials were digitized, and the IPDfromKM application was used to reconstruct the IPD. Data from different studies on the same treatments were pooled to enhance sample size, and standard statistical techniques (Cox regression, inter-treatment comparison) were employed, considering long-surviving patients (restricted mean survival time [RMST]). A heterogeneity analysis ensured comparability of patient cohorts.
Given the increasing value of indirect comparisons in both clinical and pharmacoeconomic contexts, ongoing efforts will focus on refining the analytical techniques and expanding training programs for hospital pharmacists. Future work will also explore additional therapeutic areas to broaden the impact of evidence-based medicine and enhance the role of hospital pharmacists in clinical decision-making.
Education and Research
Lamesta Chiara
Del Pizzo Mariagiovanna
Della Costanza Chiara
“SIFOgram” is an information graphic project created by the Young Area of the Italian Society of Hospital
Pharmacy (SIFO) to promote scientific divulgation not only directed to students and pharmacists but also to
a broader audience.
We inspected the development and popularity of this educational project. SIFOgram aims to create a smart and direct interaction that impact on patient perceptions, adherence, and responsibilities of hospital pharmacists in mitigating potential risks.
A graphic program was used for the creation of content published on official network pages. The references
for the subjects covered include certified bibliographies for scientific topics and digital graphics for
illustrations. The tool is applied to main topics related to contemporary health professions education
curricula, which include integrated educational designs, approvals of new drugs and supplementary
applications, new target therapies, drug dosing, and events organized by our society.
Since 1st March 2023 to 30th September 2024, we gathered +91% accounts with 12.000 reactions. Most of these interactions are for uploading of stories (67,2%) and post (28, 1%) and reels (4,5%). Of this total 3% -located across the different regions of Italy-was from general community; 2% from other European countries and outside Europe, including Africa. The age group that interacted were 25-34 ( 52,5%), -35-44 years old ( 27,4%) , 45-54 years old (9%), 55-64 years old (5%), +65 years old (2,3%). Most liked contents were : antimicrobial stewardship (average 900 views), international and national guidelines (average 650 views), management oxygen (1738 views) , conferences (average 1700 views) where healthcare professionals present their practices as leaders in their respective specialties. We invited our followers, via email, to complete a qualitative questionnaire made up of close-ended questions. 6 broad themes (each containing sub-themes) were identified: Content/clarity, Design/Layout, Audience, Graphics/Images, Interaction on social platforms (live box, chat) and References. The feedback received indicated a positive agreement.
Through this infographic project, we can gain a deeper successful use of social media in healthcare for public health awareness and improvement communication in the present and in the future.
Selection, Procurement and Distribution
A. KANDEL (1), L. CABRIT (1), C. HUMARAUT (1), A. MASSRI (2), C. TAILHADES (1), S. ARRAKI ZAVA (1), V. GRENOUILLEAU (1)
(1) Pharmacy Department, Medical Devices Unit, Pau Hospital Center, France
(2) Intensive care unit, Pau Hospital Center, France
Medical devices (MDs) and drugs account for 55% of the carbon footprint of a hospital’s French healthcare system, making this sector a key focus for the ecological transition. The MD sector alone is responsible for 32% of our hospital’s CO2 emissions, underlining the need to rethink our practices in order to reduce our environmental impact.
Elimination of waste produced unnecessarily by optimising customised packs (CP) containing the MD required for treatment.
After a multidisciplinary team (pharmacists, intensive care units, anaesthetists, nurses) was put together, packs containing unused medical devices (UMD) were identified in 2 pilot departments: anaesthesia and intensive care. The packs were weighed with and without the UMD. The savings in terms of waste weight and carbon footprint were calculated according to the type of waste: general waste or biohazardous waste. In conjunction with the medical teams and suppliers, the re-evaluation of the MD required and the withdrawal of UMDs led to the updating of CP in the pilot departments.
The packs identified include: the suture pack (SP), the central venous line pack (CVL) and the epidural pack (EP). Over one year, the weight of waste avoided was: 64 kg for the SP, 87 kg for the CVL pack, 55 kg for the EP. After modifying these packs, annual CO2 emissions were reduced by 55% for the SP, 14% for the CVL pack and 8% for the EP, with a total annual saving of €5,423. The annual weight of waste was reduced by 206 kg, a saving of 92 kg of CO2: the equivalent of 86 Paris-London train journeys.
The re-evaluation of CP can generate a significant ecological impact. This initiative is intended to be rolled out on an institutional scale, with the active collaboration of the sustainable development department, and as part of future calls for tender. These adjustments save time for care staff, significantly reduce the carbon footprint, and contribute to the ecological transition. It is essential to strike a balance between economic and environmental imperatives, given the financial constraints facing public hospitals.
Education and Research
Dückelmann Christina C., Landwehr Frauke
According to the World Health Organization, interprofessional education and collaborative practice are leading to improved health outcomes. Interprofessional education occurs when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes.
A cohort of two medical and two pharmacy students as well as four nursing trainees were selected to take over ward mangement and patient care for up to four real patients in a real hospital setting during a five weeks´ period. They were supervised by experienced professionals who “sit on their hands and look out of the window” only interfering when patients are endangered or situations are getting risky for patients.
To find out what the benefit was for pharmacy students, all six of them that where included in this year´s interprofessional wards on a cardiology and a neurology department, were interviewed using guided, problem-centred interviews. Their experiences were qualitatively explored and evaluated with regard to structure, supervsion, feedback and interprofessionality of this training.
Pharmacy students reported that the current structure, supervision and feedback enabled them to learn clinical pharmacy in a very profound way. On the other hand, it made other health care professionals aware of how they could benefit from clinical pharmacists and what the role of clinical pharmacists really is. The experience of being responsible for patients together with medical students and nursing trainees in this interprofessional setting was extremely helpful for their learning success and made them realize which influence on patients´ outcome working together in a team like that could have.
The Interprofessional Training Ward will be continued and rolled out on further departments of the hospital. In 2025, the surgery department will be part of the project. There, clinical pharmacists are badly needed. This qualitative research revealed the potential for further optimization of this programme in order to meet the learning objectives and expectations of the students even better. This will be aimed for in the next interprofessional training wards.
Education and Research
Agnese Bosio, Chiara Carcieri, Sixberth Bugeraha, Silvia Scalpello, Giovanna Fazzina, Maria Carmen Azzolina, Gianluca Miglio, Annalisa Gasco
Drug dispensing and patient monitoring are institutional activities of hospital pharmacists worldwide. Nevertheless, the enhancement of managerial capabilities, hard and soft skills is crucial to tackle the critical challenge arising from geographical, epidemiological, demographic, cultural and legislative differences between different countries.
An initiative for cooperation and interaction between hospital pharmacists from different income countries has been developed.
The initiative was led by a pharmacist from an Italian hospital who was hosted by a hospital in southern Tanzania and spent a month collaborating with local hospital pharmacists, in order to streamline integrated workflows and optimise clinical care outcomes and professional training.
A Strengths Weaknesses Opportunities Threats (SWOT) matrix was developed to assess the impact on three main areas: drug management, clinical pharmacy and pharmaceutical care.
Strengths: attitude for workflow standardisation, multidisciplinary and multicultural teamwork, sharing of expertise and best practice, speed up of limiting processes in order to develop activities in support of patients and clinicians, time and effectiveness in qualified staff training.
Weaknesses: complexity of procedures for drug import, hospital staff shortage (both pharmacists and physicians), absence of primary care and hospital-territory continuity of care network, clinical severity of patients admitted to hospital, imbalance between clinical pharmacy/pharmaceutical care in favour of drug management.
Opportunities: professional growth due to new healthcare challenges facing, soft skills improvement (problem solving, versatility, working under stress, teamwork, integration, overcoming prejudices), hard skills enhancement (logistics, international legislation, scientific English), budget optimisation for new investments (equipment/staff), improvement of patient safety and overall level of care.
Threats: language/cultural barriers, variable learning curve and resistance to change, barriers in social/professional relationships, individual variability in adaptation period, different patient perceptions of health and medical care.
Professional integration of hospital pharmacists from different educational and cultural backgrounds could enhance their ability to address different clinical, environmental and socio-economic issues, with the following outcomes: strengthening the professional pathway; optimising outcomes with consequent cost savings; improving the quality of healthcare for patients.
Clinical Pharmacy Services
Greta DUSABE, Jonathan DE GREGORI, Teo TODESCO, Vanessa GOMES, Hélène FEYEUX, Marine AGULLO, Cyril BORONAD
Chronic Obstructive Pulmonary Disease (COPD) and asthma represent a significant public health issue. Medications are administered using inhaler devices (ID) that require prior demonstration to ensure their proper use. Incorrect usage of inhaler devices might have a major influence on the clinical effectiveness of the delivered drug.
The goal of our study was to detect potential errors in the manipulation of inhaler devices (ID) and to provide patients with appropriate information on their correct use in order to improve medication management.
For this study, every hospitalised adult patient with an ongoing treatment with ID underwent a pharmaceutical interview during their hospitalisation.
This interview was done using a questionnaire assessing the patient’s knowledge of their medications and a 12-items evaluation grid covering every step of proper inhalation technique.
Between June and August 2023, 27 patients were interviewed: the average age was 73 years. 34 ID manipulations were observed. Dry powder inhalers were the most prescribed DIs (68%), followed by pressurized metered dose inhalers (23%) and soft mist inhaler (9%). For 10 DIs (29%), no explanation was given to the patient. Furthermore, inhaler technique instructions were provided by a pulmonologist (65%), general practitioner (23%), pharmacist (4%), nurse (4%) and therapeutic education program (4%). The interviews revealed that 71% of patients were not familiar with the prescribed molecules or their mechanism of action. Out of the 34 DI manipulations, only 15% were performed perfectly, and 27% were not executed properly. The steps of deep exhalation before inhalation and breath-holding after inhalation were not performed in 70% and 62% of observations, respectively. Finally, 50% of patients did not rinse their mouths after using inhaled corticosteroids.
This study has highlighted the improper use of DIs, which can lead to a loss of therapeutic effectiveness. Therefore, we have developed 9 information booklets on the correct use of the DIs that describe different handling procedures for proper inhalation. These booklets are provided at the end of the interview. Educating patients on the proper use of these inhalation devices during the initial prescription or dispensing should lead to an overall improvement in patient care.
Patient Safety and Quality Assurance
Samantha HUYNH, Catarina GONCALVES BARROSO, Sophie PATERNOTTE, Sofia DA SILVA MENDES, Claire JUDEL, Elvire MARTIN-LEMAIRE, Georges NICOLAOS, Chloé DUPONT, Nicolas CORNILLET
Raising awareness and ongoing training of healthcare professionals is a crucial criterion for High Authority for Health certification. Flashpharma provides reliable information, particularly for night-shift nurses. This becomes critical in a context of reduced physician presence and absence of pharmacists, and the increasing presence of temporary nurses due to staffing shortages.
The pharmacy department developed FlashPharma, an innovative training tool to enhance medication management within healthcare units. For instance, it contributes by promoting the proper use of high-risk medications (HRM) and risky medications (RM) by providing information to care teams as close to the patient as possible.
A working group created eleven sheets based on literature and adapted to the practices of adult hospitalization departments. Validated by medical experts and institutional committees, they include points to watch and key figures. They link up with our institutional protocols, our prescribing software and the points addressed by the visiting experts during the mock certification. Accessible by flashing QR codes strategically positioned or on our web platform, they serve as a basis for discussion with caregivers. Trainers included pharmacists, a pharmacy intern, and a hospital quality manager. Anonymous written questionnaires were used to gather feedback.
Two QR codes are placed on automated dispensing cabinets and mobile medical carts, linking to sheets on MHR, RM, and guidelines for proper drug crushing and administration via an enteral feeding tube. Another QR code on refrigerators provides information on drug storage and temperature alerts management. A label provides information on drugs prescribed outside the booklet, with six therapeutic equivalence tables validated by doctors.
Three sessions were attended by nurses, healthcare managers, orderlies, and doctors (n=18). Fifteen (83%) participants strongly agreed, and 3 (17%) agreed that they acquired new knowledge. All participants would recommend these sheets; 16 (89%) strongly expressed their willingness to participate in a second session.
Positive feedback highlighted the need for further education in various hospital units. Feedback on the use of QR codes by day and night teams will be sought during subsequent sessions and quantified using analytical dashboards. Appropriate continuing education initiatives will be implemented in paediatrics, intensive care and operating room departments.
Education and Research
RAQUEL AGUILAR SALMERÓN, LÍDIA MARTÍNEZ SÁNCHEZ, ANNA MARIA JAMBRINA ALBIACH, NEUS RAMS PLA, MANEL RABANAL TORNERO, MARIA ÀNGELS GISPERT AMETLLER, MILAGROS GARCÍA PELÁEZ, NÚRIA PI SALA, SANTIAGO NOGUÉ XARAU
HTDs in infants are defined as those that might cause severe or lethal poisoning in children. Some HTDs are considered “one pill killers”: those in which the ingestion of one unit, a single tablet or tablespoon, in an infant with a body weight of 10 kg, could be fatal. In Spain, there are 29 active ingredients (from seven therapeutic groups) considered “one pill killers”. Counseling and information are crucial activities developed by pharmacists that could help to avoid fatal intoxications.
A virtual and interactive course for pharmacists was designed to improve knowledge about highly toxic drugs (HTDs) in infants and potentially fatal intoxications. The education platform integrates microlearning and gamification methodologies, and the course could be followed via web or smartphone.
A group of experts, including toxicologist paediatricians and clinical pharmacists, carried out a literature review and determined the toxic dose for HTDs. They also determined the number of units (considering the most concentrated presentation) needed to achieve the potentially fatal dose in a 10 kg infant. A virtual microlearning platform (Snackson®) was chosen, and specific training content was designed. It will be offered to community pharmacists by our Catalan Ministry of Health.
This project has enhanced the collaboration between the group of experts and the Catalan Ministry of Health. An agreement has been signed, and, in this frame, the educational activity has been offered (Autumn 2023) to 250 community pharmacists.
A list of HTDs has been published (DOI: 10.1016/j.anpede.2020.02.007).
A video was recorded, addressed to the general population to inform them about the existence of HTDs. This video is a divulgation tool with recommendations to prevent drug poisoning and is periodically broadcast in the waiting rooms of health centers.
(https://www.youtube.com/watch?v=uSHDRte7Nr8&t=14s).
The next objective will be to evaluate the impact of the training activity on community pharmacists and the usability of the virtual microlearning platform. Future plans also include the expansion of this education tool to other regions in Spain, and to explore the application of microlearning methodology to other areas of knowledge.
Education and Research
Pascaline Hubot, Anais Lumen , Marion Lefebvre, Audrey Christiaens , Claudia Tavernier , Olivia Dalleur
With the healthcare sector’s climate footprint accounting for 4.4% (2019) of global greenhouse gas emissions, sustainable development in healthcare is one of today’s challenges. It is important and urgent to highlight the simple actions that can be implemented to reduce these emissions and to promote them. The objectives were: (1) To identify eco-friendly practices related to the pharmacist’s work. (2) To design an animated video and (3) To raise awareness among pharmacy staff about sustainable development.
Students in their final year of a complementary master’s degree in hospital pharmacy at the Université Catholique de Louvain (Belgium) decided to take on the challenge of producing an animated video on eco-actions specific to the profession of hospital pharmacist.
Firstly, a literature review (PubMed, Google Scholar) on sustainable development in healthcare followed by a focus group was carried out to identify and select ten eco-actions most relevant to the hospital pharmacist’s job. We provide at least one example for each sector of the pharmacy. Secondly, a brainstorming session was held to select the most appropriate communication tool.
An 8-minute animated video was produced using Powtoon software (January 2023 version). This video is available free of charge on Youtube (https://www.youtube.com/watch?v=5eKQVcVlP00). A poster was created for display in all hospital pharmacies in French-speaking Belgium to inform as many staff members as possible about best practices in sustainable development. A QR code was added to the poster to enable a direct access to the video. The project was presented by webinar for French-speaking Belgian hospital pharmacists in April 2023. This video is now included in the programme of a complementary Master’s degree in hospital pharmacy at the Université Catholique de Louvain.
In the face of climate challenges, raising awareness of sustainable development issues remains the watchword This educational video is a first step in initiating actions to make pharmacy more sustainable. It will be presented at the next annual meeting of French-speaking Belgian hospital pharmacists in 2024 and we hope that pharmacists will implement these concrete eco-friendly practices within their institutions.
