As we are well past a decade of experience with USP <797>, it is concerning to note that some hospital pharmacies have yet to implement an environmental monitoring program. In taking a closer look at those facilities, the numbers become more confounding, with almost four out of 10 currently not working toward implementing such a plan. The importance of establishing control in the cleanroom and monitoring any movement away from sterility cannot be understated, and without an environmental monitoring plan, there is no warning when practices begin drifting out of control. PP&P’s survey results further underscore the importance of tight environmental control by examining not only the frequency of, but also the results from, positive control media tests.