Title | A Potassium-Based Quality-of-Service Metric Reduces Phlebotomy Errors, Resulting in Improved Patient Safety and Decreased Cost. |
Publication Type | Journal Article |
Year of Publication | 2022 |
Authors | Lucas F, Mata DA, Greenblatt MB, Means J, Jarolim P |
Journal | Am J Clin Pathol |
Volume | 157 |
Issue | 5 |
Pagination | 789-798 |
Date Published | 2022 May 04 |
ISSN | 1943-7722 |
Keywords | Bias, Humans, Laboratories, Patient Safety, Phlebotomy, Potassium |
Abstract | OBJECTIVES: Poor phlebotomy technique can introduce pseudohyperkalemia without hemolysis, requiring additional workup and placing a significant burden on patients, clinical teams, and laboratories. Such preanalytical biases can be detected through systematic evaluation of potassium concentrations on a per-phlebotomist basis. We report our long-term experience with a potassium-based quality-of-service phlebotomy metric and its effects on resource utilization. METHODS: Potassium monitoring and retraining of 26 full-time phlebotomists were piloted as a quality-of-service intervention. Changes in potassium concentrations and impact on resource utilization were assessed. An algorithm for data monitoring and phlebotomist feedback was developed, followed by institution-wide implementation. RESULTS: Systematic intervention and retraining normalized K+ concentrations and lowered the percentage of venipunctures with K+ above 5.2 mmol/L, leading to a marked increase in phlebotomist compliance. This change resulted in resources savings of 13% to 100% for individual phlebotomists, reducing the total extra laboratory time required for repeat phlebotomies to determine hyperkalemia, mostly in the high-volume phlebotomist group. CONCLUSIONS: A quality-of-service algorithm that involved monitoring potassium concentrations on a per-phlebotomist basis with feedback and retraining contributed to a concrete, data-based quality improvement plan. The institution-wide implementation of this metric allowed for significant cost savings and a reduction in critical value alerts, directly affecting the quality of patient care. |
DOI | 10.1093/ajcp/aqab194 |
Alternate Journal | Am J Clin Pathol |
PubMed ID | 34932068 |
Related Faculty:
Matthew B. Greenblatt, M.D., Ph.D.