This retrospective study analyzed 10,934 hyperkalemia episodes to compare outcomes between the hyperkalemia routine group and the hyperkalemia standardized group, the latter managed with a strategy supported by the 'Serum Potassium Management Center System' in a real-world implementation setting. The study compared process and outcome metrics between this system-level intervention cohort and the routine care cohort. The hyperkalemia standardized group exhibited significantly higher rates of diagnosis (19.00% vs. 15.43%), treatment (85.23% vs. 58.29%), and review (89.41% vs. 60.86%) (all p < 0.05). With respect to disease burden, the hyperkalemia standardized group was associated with lower hospitalization costs in the chronic kidney disease-heart failure (CKD-HF) and chronic kidney disease-diabtes mellitus-heart failure comorbid subgroups, as well as shorter hospital stays in the CKD-HF comorbid subgroup (all p < 0.05). A non-significant trend toward reduced hospitalization costs and shorter hospital stays was also observed in the CKD subgroup. In conclusion, implementation of the 'Serum Potassium Management Center System' was associated with improved quality of hyperkalemia care, as reflected by more favorable process indicators and disease burden-related outcomes. This trial was registered with the Chinese Clinical Trial Registry (ChiCTR) ChiCTR2600116550 on January 12, 2026.