The “rapid cycle nurse” position was created for a Registered Nurse who had experience dealing with geriatric clients. A checklist was developed to identify appropriate patients which included: greater than 65 years, living in own home, and having an identified need: fall potential, poor hygiene, or taking numerous medications.  

Each day, the rapid cycle nurse is assigned to four patients. The nurse will assess these patients thoroughly to identify specific needs. Special geriatric testing will be done including mini mental status exam, Montreal cognitive assessment, geriatric depression scales and others. A toolbox was created to store all available tests for nursing staff. In addition, a checklist was designed by the rapid cycle nurse to identify patient problems and possible solutions. 

The rapid cycle nurse works with other members of the health care team including physicians, therapists, dietitians, and community agencies to decide on appropriate treatment and to arrange care, both in hospital and in community.  

We are in the process of evaluating this service through readmission rates, but do not believe that this tells the entire story. We believe that this concept of identifying those at high risk and assisting them to return to their homes following proper assessment and with community services will contribute to better quality of care, and will ultimately save the health care system dollars.