**Background:** Hospital pharmacies play a central role in ensuring safe and effective pharmacotherapy, yet their organization varies widely across countries. In Poland, most hospitals still rely on traditional drug distribution methods (ward-based first aid kits), while Western European countries have adopted automated systems. This narrative review aims to outline the functions of hospital pharmacies, the evolving role of pharmacists, and the impact of modern versus classical drug distribution systems on patient care quality.
**Methods:** This is a narrative review drawing on Polish pharmaceutical law (Pharmaceutical Law Act of September 6, 2001), regulatory documents (e.g., Regulation of the Minister of Health on Good Distribution Practice, WHO Operational Principles for Good Pharmaceutical Procurement), and published literature. The authors describe the statutory tasks of hospital pharmacies, the responsibilities of hospital pharmacists, technical requirements for pharmacy premises, and compare classical and modern drug distribution systems. Data on the number of hospital pharmacies in Poland are from the Central Register of Pharmacies (September 9, 2022), which reported 565 hospital pharmacies and 1035 hospital pharmacy departments.
**Key Results:** The review presents several quantitative findings from cited studies: (1) Public expenditure on medical products in Poland amounts to 22.7% of total healthcare expenditure by function. (2) In the unit-dose system, error rates at the drug preparation stage range from 2.5% to 10.9%, mainly due to omission of a drug dose (30.2%) and dispensing an incorrect dose (31.8%). (3) Fontan et al. reported that handwritten prescriptions had an error rate of 87.9%, while computer-based prescriptions had an error rate of 10.6% (statistically significant difference). (4) The unit-dose system can save up to 25% of a pharmacist's working time. (5) At the Dr. W. Bieganski Regional Specialist Hospital in Grudziądz, the system cost 7.9 million PLN (1.65 million euros) to implement, with annual savings from reduced overdue drugs estimated at 140,000 PLN (30,000 euros). (6) A 2016 study by Żuk et al. confirmed user satisfaction and benefits of the unit-dose system. The multi-dose system is described as offering comprehensive drug management including automated warehousing, robotic dispensers in wards, and computerized e-carts, but specific cost or error-rate data are not provided. The review notes that in the classical distribution system, drugs are dispensed to ward first aid kits without pharmacy control over actual administration, and handwritten orders remain common. Disposal costs for expired drugs are described as "constantly increasing."
**Clinical Implications:** The review argues that automated drug distribution systems (unit-dose and multi-dose) improve patient safety by reducing medication errors, enabling pharmacist review of all prescriptions for interactions and dosing, and minimizing waste from expired or unused drugs. The unit-dose system allows pharmacist-controlled delivery of individually packaged, ready-to-administer doses identified by barcodes, which reduces nursing errors and frees nursing time for direct patient care. The multi-dose system extends automation to ward-level dispensing with robotic cabinets. Both systems require significant upfront investment, hospital-wide computerization, staff training, and reorganization of workflows. The authors conclude that despite implementation barriers in Poland (limited finances, insufficient computerization, need for 24/7 pharmacy operation), automated distribution should be the target model because it offers "invaluable therapeutic, economic, and organizational benefits." The review emphasizes that hospital pharmacists should increasingly participate in therapeutic committees, hospital formulary development, and direct collaboration with physicians to optimize pharmacotherapy, particularly for polytherapy patients.