Abstract Background Patients with inflammatory bowel disease (IBD) have chronic, life-long diseases with relapsing-remitting pattern that often require frequent utilization of healthcare services.[1] Urgent access to specialty care can help identify patients with acute medical needs so they can receive appropriate care in a timely manner. This can avoid unnecessary high-cost medical interventions, such as visits to the emergency department (ED), which often lead to excess use of steroids, narcotics, and radiographic imaging, all important measures of quality of IBD care.[2] We sought to introduce an access/quality improvement program at a private gastroenterology practice with the goal of triaging and returning urgent calls from IBD patients in a timely manner and mitigate avoidable visits to the ED. Methods Gastroenterologists, nurses, and support staff at our private practice developed four criteria for “urgent” IBD calls: new, severe abdominal pain; new, severe anal pain; fever greater than 101 Fahrenheit; and refractory emesis. Patient calls that met any of these criteria were highlighted with a red flag and labelled as “IBD URGENT” by support staff in the electronic medical system. The primary gastroenterologist (or covering provider) then responded to these calls as soon as possible with a goal of responding within 4 hours. Subsequently, patients were advised to go to the ED for further emergent evaluation, given same/next day clinic visits, and/or given advice, such as medication changes, by the gastroenterologists. Results Over a 15-month period from June 2018 to August 2019, we received a total of 167 “IBD URGENT” calls (average 11 calls per month); of these, 92% (153 calls) received a response from a gastroenterologist within 4 hours. Abdominal pain, diarrhea, blood in the stools, and vomiting were the most common reasons for urgent calls. Only 10% (16 calls) of calls were patients with worrisome symptoms in which they were advised to go to the ED, 37% of calls led to same/next day clinic visits (62 calls), and 58% resulted in advice/orders from the gastroenterologist such as laboratory testing, medication continuation/changes (97 calls); 12% (20 calls) resulted in both urgent clinic visits and advice (e.g., obtain laboratory testing and then present for office visit). Conclusion We piloted an urgent care hotline for IBD patients to receive rapid medical access at a private community gastroenterology practice. The majority of patients were successfully managed with outpatient medical care, including same/next-day office visits and advice for laboratory testing/medication changes. Only a minority (10%) of calls resulted in ED visits. We plan to continue this project with the aim to return more than 90% of the urgent calls within 4 hours. References