S1867 Implementation of a Nurse Practitioner-Led Rapid Access Clinic for Patients With Inflammatory Bowel Disease: A Quality Improvement Project

Introduction: Inflammatory Bowel Disease (IBD) is a chronic condition marked by frequent flares that often result in emergency department (ED) visits and hospitalizations. Notably, IBD ranks among the top 5 most expensive gastrointestinal conditions, with acute episodes contributing to significant healthcare costs and patient burden. This quality improvement project aimed to reduce preventable ED visits and hospitalizations through the implementation of a nurse practitioner-led Rapid Access Clinic (RAC) at a tertiary IBD center. Methods: The RAC targeted established IBD patients at high risk for acute care utilization including those with recent hospitalizations, steroids use, nonadherence to therapy. Patients were identified via EMR review and scheduled for timely in-person or telehealth visits. Data on ED visits and hospitalizations were collected using the IBD Qorus survey for 3 months before and after RAC implementation. Statistical analysis was conducted using chi-square tests. Results: Over a 12-week period, 144 RAC visits were completed with 134 unique patients. Hospitalizations rates declined from 13.6% to 9.8%, and ED visits decreased from 15.5% to 9.7% post-implementation. These reductions suggest clinical relevance, particularly given baseline rates exceeding 10%. Stakeholders opted to sustain the RAC based on these outcomes. Conclusion: The nurse practitioner-led RAC demonstrated potential to reduce acute care utilization in IBD patients through proactive, accessible outpatient management. This model supports improved patient outcomes, reduced healthcare costs, and may be scalable to the chronic disease populations.