The New York City, New York (NYC) RxStat initiative was established in 2012 and has included overdose fatality review (OFR) meetings since 2016. The past 2 years have brought many changes to RxStat. Today, RxStat has three meeting types, each with a clear goal and structure. These meeting types include:

• Drug trends meetings, which focus on high-level overdose trends and policies.
• OFR meetings, designed to unearth missed opportunities for overdose prevention and intervention.
• Action meetings, which create shared accountability and result in concrete recommendations and action items.

NYC has more than 2,000 fatal overdoses each year; the RxStat initiative cannot hope to review every case in its OFR meetings. Instead, it selects cases by theme to help focus the conversation in each OFR. Then, a subsequent action meeting focuses on how to take the gaps identified during the OFR and turn them into specific, achievable recommendations. In this presentation, the RxStat initiative will provide an overview of the goals and structure for all three meeting types and provide one to two case studies that provide an overview of:

• A theme the RxStat initiative chose for an OFR meeting.
• The process for selecting OFR cases that fit that theme.
• Gaps identified during the OFR meeting.
• Recommendations generated by the action meeting, including any workgroups created.
• Final actionable outcomes that resulted from the process.

This presentation showcases how RxStat moves from OFR case review to action and will provide examples of OFR themes that have resulted in fruitful discussion and action in NYC.