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American Journal of Medical Quality, Vol. 21, No. 2, 115-124 (2006)
DOI: 10.1177/1062860605285047

Follow-up of Markedly Elevated Serum Potassium Results in the Ambulatory Setting: Implications for Patient Safety

Carlton R. Moore, MD

Division of General Internal Medicine, Mount Sinai School of Medicine, 1470 Madison Avenue, New York, NY 10029. carlton.moore{at}mssm.edu

Jenny J. Lin, MD

Nicky O'Connor, RN

Division of General Internal Medicine, Mount Sinai School of Medicine, New York, New York.

Ethan A. Halm, MD, MPH

Department of Health Policy, Mount Sinai School of Medicine, New York, New York.

Failure to follow up outpatient test results in a timely manner is a growing patient safety concern. To investigate the follow-up of markedly elevated serum potassium levels in the ambulatory setting, the authors reviewed the medical records of all patients seen in a large primary care practice between September 1, 2003, and August 31, 2004, with potassium levels≥5.8mEq/L. Of the 12914 serum potassium tests performed, there were 109 cases of markedly elevated serum potassium levels in 86 patients. The median potassium level was 5.9mEq/L (range, 5.8-7.3). More than half the patients were recalled to the clinic specifically for repeat testing; however, 25% of patients had no repeat tests until they were seen at routine follow-up visits. The median time to a repeat potassium level was 6 days (range, 0-445). Patients≥65 years old had a lower likelihood of having repeat testingwithin 1 week (odds ratio = 0.38,P= .03).

Key Words: labs • follow-up • hyperkalemia • ambulatory


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