Practice and Exploration of Target Management Model for Clinical Pharmacists in Primary Hospitals

Objective: To explore the target management model for clinical pharmacists in primary hospitals facing current shortages of clinical pharmacists, in order to improve the work efficiency and service quality of clinical pharmacy, and promote the high-quality development of clinical pharmacy in primary hospitals. Methods: Developing a target management model, adopting a wide coverage work model of “1+1+N” (that is, 1 clinical pharmacist, 1 resident clinical department, and N contracted clinical departments). According to the SMART principle, various work assessment indicators were quantified. This involved setting clear work goals, diversifying work methods, personalizing work methods, standardizing workflows, and using numerical assessment indicators. Regular supervision, inspection, feedback, and improvement mechanisms were implemented. Results: The implementation of the target management model has made the work effectiveness of clinical pharmacists visualized. There were more than 200 annual consultations and multidisciplinary team (MDT) cases, with an opinion adoption rate of 90.2% and a patient improvement rate of 80.6%. More than 1500 rational drug use interventions were conducted, with a suggestion adoption rate of 83.5%. In terms of pharmaceutical indicators control. The intensity of antibacterial drug use in 2024 (without CMI adjustment) was 30.07 DDDs, significantly lower than the 2023 value of 33.54 DDDs, and also significantly lower than the provincial average (32.87 DDDs) and the average for hospitals of the same level (32.49 DDDs). The daily usage of intravenous infusion per bed for hospitalized patients was 2.09, a decrease from 2.15 in 2023, significantly lower than the provincial average of 2.71 and the average of 2.56 in hospitals of the same level. The amount of the second batch of national key monitoring drugs accounts for the value was 6.48%, significantly lower than the provincial average of 8.27% and the same level hospital average of 8.82%. In terms of chronic disease pharmaceutical management, taking the pharmaceutical management of patients with chronic heart failure as an example, the usage rates of RA inhibitors and β-blockers for heart failure in the management group were 87.88% and 80.81%, respectively, significantly higher than those in the control group (62.22% and 65.56%). Heart rate in the management group (69.54 ± 10.68 times·min-1 ) was significantly lower than in the control group (80.04 ± 17.68 times·min-1 ) (P < 0.001). The low-density lipoprotein (1.69 ± 0.57 mmol·L-1) was significantly lower than the control group (1.95 ± 0.77 mmol·L-1) (P < 0.001), and the 1-year readmission rate was 47.47%, significantly lower than the control group 56.67%. The Minnesota Quality of Life Score was (44.20 ± 10.78), significantly lower than the control group (55.89 ± 11.48) (P < 0.001), indicating a significant improvement in the patient’s quality of life. Conclusions: The targeted management model for clinical pharmacists can effectively enhance communication and collaboration between clinical pharmacists and clinicians, improve the work efficiency and service quality of clinical pharmacists in primary hospitals, promote the work of clinical pharmacy towards standardization and scientificization, boost the high-quality development of pharmacy in primary hospitals, and also provide new ideas and methods for the management of clinical pharmacists in other primary hospitals.