P5314 - Implementation of a Nurse Practitioner-Led Rapid Access Clinic for Patients With Inflammatory Bowel Disease: A Quality Improvement Project

Award: ACG APP Outstanding Research Award

Award: ACG Presidential Poster Award

Megan Pearce, DNP, APRN, FNP-C¹, Donna Ortiz, DNP, APRN, FNP-C², Catherine Nadeau, ARNP³, Jennifer Seminerio, MD²
1AdventHealth, Orlando, FL; 2Department of Gastroenterology and Hepatology, AdventHealth Orlando, Orlando, FL; 3University of South Florida, Tampa, FL

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 five 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 three 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.

Discussion: 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.


Figure: Figure 1. Hospitalization rates from IBD Qorus Survey
Table 1. Hospitalization rates pre and post-implementation of RAC
Figure 2. ED utilization rates from IBD Qorus Survey




Figure: Table 2. ED Utilization rates pre and post-implementation of RAC
Figure 3. ED or Hospitalization within 30 days after RAC visit
Figure 4. Race/Ethnicity of patients utilizing RAC
Figure 5. Median Time to RAC visit

Disclosures:
Megan Pearce: Johnson and Johnson – Advisor or Review Panel Member.
Donna Ortiz: Abbvie – Consultant, Speakers Bureau. BMS – Speakers Bureau. Celltrion – Speakers Bureau. Johnson & Johnson – Advisor or Review Panel Member, Speakers Bureau. Lilly – Consultant, Speakers Bureau.
Catherine Nadeau indicated no relevant financial relationships.
Jennifer Seminerio: Abbvie – Consultant. Johnson & Johnson – Consultant. Lilly – Consultant. Pfizer – Consultant. Sanofi – Consultant. Takeda – Consultant.

Megan Pearce, DNP, APRN, FNP-C¹, Donna Ortiz, DNP, APRN, FNP-C², Catherine Nadeau, ARNP³, Jennifer Seminerio, MD². P5314 - Implementation of a Nurse Practitioner-Led Rapid Access Clinic for Patients With Inflammatory Bowel Disease: A Quality Improvement Project, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.