{"success":true,"data":{"_id":411782168,"filings":[{"Organization":{"Hours":[0],"Total Compensation":[0],"Direct compensation":[0],"Other compensation":[0]},"Basic":{"mission":"See sch. O - the organization's mission, & sch. O - exempt purpose and achievements","primary_activities":"The mission of the institute for clinical systems improvement (icsi) is to champion the cause of health care quality and to accelerate improvement in the value of the health care its stakeholders deliver to the populations they serve. Icsi's vision is to be a collaboration that is deemed essential by its members for their improvement of health care and deemed essential by the community as a trusted voice for quality in health care.\n\nI. Organization and governance icsi is a nonprofit minnesota corporation exempt from income tax under section 501(c)(3) of the internal revenue code (\"irc\") and is not a private institution as defined by section 509(a) of the irc. Icsi is governed by a board of directors. The mission of icsi is to champion the cause of health care quality and to accelerate improvement in the value of health care delivered by medical groups, hospitals and health plans to people who live and work in the state of minnesota and in adjacent areas of surrounding states. Icsi has 63 members and is funded by five minnesota and wisconsin health plans. The combined medical groups, hospitals, and integrated systems represent approximately 9,000 physicians. As part of its commitment to support quality improvement, icsi has accomplished the following. Ii. Icsi's activities 1. Establish best clinical practices - icsi develops and publishes 31 health care guidelines for use by providers and patients in defining best care for a variety of medical conditions and preventive services. Icsi reviewed and approved 20 guidelines in 2010 to make sure they reflect the most current medical evidence. In addition, icsi's patient advisory council began providing feedback on multiple guidelines. Icsi also strengthened its conflict of interest criteria for work group members and reviewers to help ensure that its guidelines remain credible throughout the health care community. - icsi develops and publishes 14 order sets for use by hospitals, especially those that use electronic health record systems. An order set consists of standardized instructions for the management of a particular disease, condition or procedural intervention, presented as a group of orders to be individually selected and signed by an authorized prescriber. - icsi develops and publishes six health care protocols for use by providers. Health care protocols are step-by-step statements of procedures routinely used in the care of patients to ensure that the intended outcome is reliably achieved. Icsi makes all of its guidelines, order sets and protocols available to the public at no charge on the icsi web site at www.icsi.org. 2. Provide education on quality improvement & health care topics - icsi offered one cycle of its cultivating quality series of workshops to teams from six organizations that participate in icsi. Cultivating quality is a structured curriculum that covers a broad range of topics such as consensus building, implementation, leadership, and change management. - icsi conducted workshops on motivational interviewing and patient safety. Webinars were also held on such topics as accountable care organizations, developing aims and measures, comparative effectiveness, using decision-support tools, and communication strategy to alleviate the impact of depression on patient behavior and health. Icsi also launched the \"icsi ideagora,\" monthly discussions with providers and other stakeholders on such topics as the future of primary care and participatory medicine. 3. Icsi collaborated with the institute for healthcare improvement to present a conference whose theme was innovation and quality in a time of health care reform. 4. Support collaborative quality improvement initiatives - icsi focused on a number of strategic initiatives so that care provided by its members is more patient-centered and value-driven. In 2010, a total of 75 clinics offered the diamond program, which changes the way care for patients suffering from depression is delivered and paid for in primary care. This program is getting four times as many patients into remission by six months compared to patients receiving typical primary care treatment. Icsi also explored how the diamond model could extend beyond depression to similarly improve patients' outcomes in other chronic conditions such as diabetes, hypertension, and hyperlipidemia, and in other behavioral health issues, such as screening for both depression and substance abuse in primary care clinics. Following the development and three-year piloting of a decision-support option for ordering appropriate high-technology diagnostic imaging (htdi) scans, icsi began to make this option available to all care delivery systems in minnesota in late 2010. The option allows providers to order htdi scans during an office visit with the patient, rather than requiring health plan pre-authorization, by using criteria based on american college of radiology imaging standards. The criteria can be embedded in an electronic health record system or accessed via the web. To support its health care home initiative, icsi helped its members change their care processes to become state certified, applied lessons learned from the diamond model to health care home development, and collaborated with the university of minnesota to develop a common lexicon to help define the components necessary for a health care home. - a fourth initiative on palliative care was developed to the point where its key elements and findings could be applied to other icsi work, such as in the area of health care homes and shared decision making. 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Icsi's vision is to be a collaboration that is deemed essential by its members for their improvement of health care and deemed essential by the community as a trusted voice for the improved health of the population, experience of the patient and affordability of health care. Icsi has 53 members and is funded by five minnesota and wisconsin health plans. The combined medical groups, hospitals, and integrated systems represent approximately 9,000 physicians. As part of its commitment to support quality improvement, icsi has accomplished the following. Ii. Icsi's activities 1. Establish best clinical practices - icsi develops and publishes 32 health care guidelines for use by providers and patients in defining best care for a variety of medical conditions and preventive services. Much of icsi's work on its evidence-based guidelines in 2012 continued to focus on improvements to meet or exceed the updated standards released by the institute of medicine. Icsi revised 21 guidelines and protocols in 2012, collaborating with other guideline developers to share expertise and resources to enhance icsi's evidence work. 2. Provide education on quality improvement & health care topics - icsi offered one cycle of its cultivating quality series of workshops to teams from three organizations that participate in icsi. Cultivating quality is a structured curriculum that covers a broad range of topics such as consensus building, implementation, leadership, and change management. - icsi conducted workshops on motivational interviewing and patient safety. Webinars were also held on such topics as accountable care organizations, developing aims and measures, comparative effectiveness, using decision-support tools, and communication strategy to alleviate the impact of depression on patient behavior and health. Icsi also continued the \"icsi ideagora,\" monthly discussions with providers and other stakeholders on such topics as the future of primary care and participatory medicine. - icsi presented a workshop in conjunction with its annual reinertsen lecture whose theme was \"accountable healthy communities\" looking at strategies to cooperatively improve health and health care at the community level. 3. Support collaborative quality improvement initiatives - in 2012 icsi continued its initiative to reduce avoidable readmissions effectively (rare) in partnership with the minnesota hospital association, stratis health and over 76 other organizations. The rare campaign had a goal of preventing 4,000 avoidable readmissions by the end of 2012, and exceeded that number with a final tally of 4,570 readmissions avoided across 82 hospitals statewide. Based on an average length of stay in a hospital, this represents 14,412 nights of patients sleeping in the own beds and more than $45 million in cost savings. - building on previous work with the diamond program for depression, the sbirt program, and health care homes over the past five years, in 2012 icsi launched new integrated behavioral health and primary care initiative entitled \"care of mental, physical and substance use syndromes\" (compass). Funded by a three-year cooperative agreement with the centers for medicare and medicaid services (cms), icsi is leading a consortium of ten medical groups across eight states to implement a new care management model for patients with diabetes or cardiovascular disease who also suffer from depression and possibly risky substance use. If compass proves successful, it holds the potential to alter how patients with chronic conditions are treated and how primary care is reimbursed by cms moving forward. - icsi completed a multi-year statewide initiative in 2012 offering medical groups and hospital-based clinics a decision-support tool that enabled providers to order high-technology diagnostic imaging (htdi) scans while with their patients. This project focused on helping clinics adopt a more efficient, patient-centered, and cost-effective option that offered advantages over contacting a radiology benefit management firm for prior notification. Icsi estimates that 78% of minnesota medical groups are using decision support, holding increases in htdi claims to 1% (in 2007-2012) down from 8% (2003-2006) for an estimated savings of $150 million. 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Icsi's vision is to be a collaboration that is deemed essential by its members for their improvement of health care and deemed essential by the community as a trusted voice for the improved health of the population, experience of the patient and affordability of health care. Icsi has about 55 members and is funded by three minnesota health plans. The combined medical groups, hospitals, and integrated systems represent approximately 8,000 physicians. As part of its commitment to support quality improvement, icsi has accomplished the following in 2015. Ii. Icsi's activities improve affordability - icsi was asked, as a neutral convener, to bring together key stakeholders to address concerns about the prior authorization process for medication ordering. This work group analyzed key issues around medication utilization management/prior authorization in minnesota and outlined opportunities for improvement. Because prior authorization is only one of the components, the work group also included step therapy, quantity limits, and medical necessity as they designed an improved process. - icsi continued to make addressing \"affordability\" as legitimate an issue as improving quality by integrating this triple aim goal into all icsi projects. Improve the experience of care, including quality - compass, a three-year health care innovation award from the centers for medicare and medicaid services, was completed in june 2015. This project, which involved 18 medical groups (four in minnesota), 171 clinics and 3,300 clinicians in eight states, focused on improving outcomes in patients with active depressive symptoms and poorly controlled medical co-morbidities. Preliminary results include: 24% of patients achieved depression remission, 23% of patients achieved glucose control, and 53% of patients achieved blood pressure control. - icsi currently has 39 guidelines available on its website. Icsi revised four of them in 2015. - through a grant from the agency for healthcare research and quality (ahrq), icsi is partnering with mayo clinic to support the use of shared decision-making (sdm) tools as standard practice in six sites. - icsi partnered with ramsey county public health to create a culturally tailored best practices document to help hmong patients in areas of nutrition, physical activity and tobacco cessation. - clinical decision support (cds) provides clinicians, staff, patients, and others with tools to help effectively and efficiently filter information and tailor health care to individual needs. Icsi seeks to leverage a variety of cds approaches and tools within our guidelines program and other high impact areas. In 2015, we reviewed 38 resources, and our online repository now includes 22 tools. We also improved the website to make this a more valuable resource for our members. - the mental health community partners network offers an opportunity for hospital representatives to connect and collaborate with their community partners to improve care transitions for people with mental illness. An outgrowth of the rare (reducing avoidable readmissions effectively) mental health collaborative, this networking initiative, which continues into 2016, utilizes meetings, webinars, and a linkedin group to share information on bright spots in care transitions and helps develop collaboration skills. This initiative is made possible through the minnesota hospital association's hospital engagement network, funded by the partnership for patients program of the centers for medicare and medicaid services. - thomas a. Laveist, phd, captivated a full house of more than 200 people at reinertsen lecture. - icsi hosted two webinars focusing on the benefits and use of data released by minnesota community measurement (mncm) on race, hispanic ethnicity, and language, with approximately 50 attendees participating per session. - through funding from a state innovation model (sim) grant, icsi began a partnership with stratis health to provide practice facilitation to 10 primary and specialty clinics across minnesota, representing about 140 clinicians, through december 2016. Focus areas for improvement work include total cost of care, chronic disease management, health care home certification, health it, behavioral health integration, alternative care models, and general quality improvement. - icsi, in collaboration with healthpartners research & education, the minnesota department of health (mdh), and stratis health, began work on a chronic condition management program. 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THE STATE OF MINNESOTA MONITORS THE PUBLIC BENEFIT OF THESE ORGANIZATIONS ANNUALLY TO ENSURE THAT THEY MEET STATE AND FEDERAL REQUIREMENTS."},{"form_and_line_reference":"IV, A, 3C - SUPPORTED ORGANIZATIONS","explanation":"ICSI DOES NOT PROVIDE FINANCIAL SUPPORT TO ITS SUPPORED ORGANIZATIONS THAT ARE 501(C)(4) ORGANIZATIONS. THE MISSION OF ICSI IS TO CHAMPION THE CAUSE OF HEALTH CARE QUALITY AND TO ACCELERATE IMPROVEMENT IN THE VALUE OF THE HEALTH CARE ITS SUPPORTED ORGANIZATIONS DELIVER TO THE POPULATIONS THEY SERVE. 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O - the organization's mission, & sch. O - exempt purpose and achievements","primary_activities":"The mission of the institute for clinical systems improvement (icsi) is to champion the cause of health care quality and to accelerate improvement in the value of the health care its stakeholders deliver to the populations they serve. Icsi's vision is to be a collaboration that is deemed essential by its members for their improvement of health care and deemed essential by the community as a trusted voice for quality in health care.\n\nI. Organization and governance icsi is a nonprofit minnesota corporation exempt from income tax under section 501(c)(3) of the internal revenue code (\"irc\") and is not a private foundation as defined by section 509(a) of the irc. Icsi is governed by a board of directors. The mission of icsi is to champion the cause of health care quality and to accelerate improvement in the value of the health care its stakeholders deliver to the populations they serve. Icsi's vision is to be a collaboration that is deemed essential by its members for their improvement of health care and deemed essential by the community as a trusted voice for quality in health care. Icsi has 53 members and is funded by five minnesota and wisconsin health plans. The combined medical groups, hospitals, and integrated systems represent approximately 9,000 physicians. As part of its commitment to support quality improvement, icsi has accomplished the following. Ii. Icsi's activities 1. Establish best clinical practices - icsi develops and publishes 31 health care guidelines for use by providers and patients in defining best care for a variety of medical conditions and preventive services. Much of icsi's work on its evidence-based guidelines in 2011 involved improvements to meet or exceed new standards released by the institute of medicine. Icsi revised 19 guidelines and three protocols in 2011, and also made the improvement of incorporating order sets into the guidelines. An order set consists of standardized instructions for the management of a particular disease, condition or procedural intervention, presented as a group of orders to be individually selected and signed by an authorized prescriber. 2. Provide education on quality improvement & health care topics - icsi offered one cycle of its cultivating quality series of workshops to teams from six organizations that participate in icsi. Cultivating quality is a structured curriculum that covers a broad range of topics such as consensus building, implementation, leadership, and change management. - icsi conducted workshops on motivational interviewing and patient safety. Webinars were also held on such topics as accountable care organizations, developing aims and measures, comparative effectiveness, using decision-support tools, and communication strategy to alleviate the impact of depression on patient behavior and health. Icsi also continued the \"icsi ideagora,\" monthly discussions with providers and other stakeholders on such topics as the future of primary care and participatory medicine. - icsi presented a conference whose theme was total cost of care (tcoc) and affordability in the setting of the triple aim in a time of rising health care costs. 3. Support collaborative quality improvement initiatives - in 2011 icsi launched an initiative to reduce avoidable readmissions effectively (rare) in partnership with the minnesota hospital association, stratis health and over 60 other organizations. Launched in july, the campaign called upon hospitals and others in the care continuum to focus on five key areas known to reduce avoidable readmissions, with a goal of a 20% reduction by the end of 2012. By year's end, 76 minnesota hospitals accounting for more than 80% of the state's annual readmissions were participating and had completed an organizational assessment of their readmissions. - after three years and more than 8,000 activated patients, the diamond program continued to prove it is a highly effective model for treating patients with depression. By the end of 2011, diamond clinics collectively reported 30% of their patients with depression were in remission by six months. These results are six times better than results reported on clinics statewide by minnesota community measurement. Icsi's activities in 2011 focused on how well the model could manage more behavioral health and/or chronic diseases. As part of a federal grant from the agency for healthcare research and quality, icsi and two other partners worked to create a model that combines the diamond program with the sbirt (screening, brief intervention, referral to treatment) program for substance abuse. Twenty-two diamond clinics began to additionally screen to identify and address substance abuse in patients in late 2011. - following an intensive pilot, icsi launched a statewide initiative at the end of 2010 to offer medical groups and hospital-based clinics a decision-support tool that enables providers to order high-technology diagnostic imaging (htdi) scans while with their patients. In 2011, icsi focused on helping clinics adopt this more efficient, patient-centered, and cost-effective option which offers advantages over contacting a radiology benefit management firm for prior notification. Icsi estimates that 75% of htdi claims being filed at the end of 2011 were ordered using decision support. 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Icsi's vision is to be a collaboration that is deemed essential by its members for their improvement of health care and deemed essential by the community as a trusted voice for the improved health of the population, experience of the patient and affordability of health care. Icsi has approximately 50 member medical groups and three minnesota health plans which provide the majority of funding. The combined medical groups, hospitals, and integrated systems represent approximately 8,500 physicians. As part of its commitment to support quality improvement, icsi has accomplished the following in 2017. Ii. Icsi's activities the mn health collaborative is a powerful example of minnesota's healthcare community's commitment and ability to collaborate - even while being competitors - to better serve our patients, families, and communities. With icsi serving as its backbone organization, the mn health collaborative includes physicians and other representatives from major healthcare organizations working together to address major health topics affecting minnesota communities today including opioid misuse and addiction as well as system improvements to address broader mental health care needs. Health systems in the minnesota health collaborative currently include allina health, centracare health, children's hospitals and clinics of minnesota, essentia health, fairview health services, healthpartners, hennepin county medical center, hutchinson health, mayo clinic, medica, north memorial health, ridgeview medical center, sanford health, ucare, and university of minnesota health/university of minnesota physicians. Icsi revised six guidelines in 2017. 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Icsi is partnering with clearway minnesota to increase the capacity of health systems to address tobacco cessation with practical offerings that connect people and provide real-world examples of effective methods and practices at the clinic level. Work continues with regional workshops and practice facilitation opportunities including six \"jump start\" on-site offerings in motivational interviewing and clinician-focused education on nicotine replacement therapy (nrt) and other medications. As the sim practice facilitation work continues through june 30, 2017, five current partners (appleton, bluestone, catholic charities, madison and hcmc east lake clinic), as well as new clinics from ortonville area health services (northside medical clinic) and the two new clinics from hcmc (golden valley and brooklyn center) embark on focused improvement work. Each clinic has connection with a practice facilitation coach to set focus and goals for the contract period. 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Organization and governance icsi is a minnesota nonprofit corporation exempt from income tax under section 501(c)(3) of the internal revenue code (\"irc\") and is not a private foundation as defined by section 509(a) of the irc. Icsi is governed by a board of directors. Icsi's mission is to champion the cause of health care quality and to accelerate improvement in the value of the health care delivered to the populations they serve. Icsi's vision is to be a collaboration that is deemed essential by our members for their improvement of health care and deemed essential by our community as a trusted voice for quality in health care. Icsi has about 50 member medical groups and three minnesota health plans which provide the majority of funding. The combined medical groups, hospitals and integrated systems represent approximately 8,500 physicians. As part of its commitment to support quality improvement, icsi has accomplished the following in 2018. Ii. Icsi's activities the mn health collaborative is a powerful example of minnesota's healthcare community's commitment and ability to collaborate - even while being competitors - to better serve our patients, families, and communities. With icsi serving as its backbone organization, the mn health collaborative includes physicians and other representatives from major healthcare organizations working together to address major health topics affecting minnesota communities today including opioid misuse and addiction as well as system improvements to address broader mental health care needs. Health systems in the minnesota health collaborative currently include allina health, centracare health, children's minnesota, essentia health, fairview health services, gillette children's specialty healthcare, healthpartners, hennepin healthcare, hutchinson health, mayo clinic, medica, north memorial health, ridgeview medical center, sanford health, ucare, university of minnesota health/university of minnesota physicians, and united healthcare of mn, nd and sd. Collaborative event the mn fierce: tackling mental health and the opioid epidemic brought together 89 mn health collaborative working group participants, in addition to new organizational staff and non-collaborative icsi members. To assure that the patients we are serving were top of mind, the day was started with a presentation by bridgit duffey who shared her experience as a child and an adult with a brother who suffered from addiction. During the remainder of the day, the participants developed a broader understanding of the work being done by other working groups, and began conversations about common strategies and goals across the opioid and mental health work. Individual working groups met independently, to further specific work. As one participant said, \"it helps to meet in person. And there is great value to being able to stay focused on this work for a full day.\" icsi revised one guideline in 2018 adult acute and subacute low back pain, completed a commentary on conflicting national guidelines on the care of hypertension and an evidence brief on e-cigarettes. Icsi successfully completed the contract deliverables for the tobacco systems change capacity building initiative which ended 06/30/18. Key deliverables included: a toolkit that was created, curating key resources and practical tools to help clinics and health systems improve how they address tobacco use. Jump start training: these targeted training sessions were attended by 107 clinic staff from seven community health centers. Sessions consisted of 30-60 minute trainings on motivational interviewing to address tobacco and nicotine use for any and all staff interested, and medication/nrt education for clinicians. An article \"jump starting tobacco health systems change\" will be published in the fall sept/oct. Issue of metrodoctors. Icsi has a contract (july 01, 2018 - march 31, 2019) to deliver a total of five additional jump start trainings for fqhc clinics that have not yet had this training. Cmmi support and alignment network (nrhi san) the 2018 contract had a revised sow with an additional $10,000 payment to icsi to conduct, in-person motivational interviewing workshops to the san ptn groups in kentucky and california. The contract for continued technical assistance for the san runs sept 2018-sept 2019. Chronic condition management (ccm) the multi-year contract for chronic condition management (ccm) officially ended on june 29, 2018; however, minnesota department of health (mdh) has granted a three-month extension, which ran from june 30 - september 30, 2018. During this time icsi provided technical assistance and support on pre-visit planning at entira family clinics. Mdh has a new multi-year grant oportunity for cardiovascular health and diabetes as a subcontractor in a proposal submitted by healthpartners institute. If awarded, work would begin in september 2018. This would provide the federally qualified urban health network (fuhn) ihp, a group of 10 local fqhc's free access to technical assistance skilled practice coaches, training events networking and collaborative opportunities, and support for evidence-based care dissemination. These clinics would also explore the possibility of using healthpartners' cv wizard as a decision support tool. 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We are an independent, nonprofit health care improvement organization with approximately 40 members (medical groups, hospitals, and health plans) and active connections with and broad representation of employers and consumers. These healthcare organizations provide care or insurance to close to 75% of mn citizens. We partner with state health and public health agencies, professional health care associations, regional health collaboratives and others in minnesota and across the nation who have aligned missions. Icsi is a nonprofit minnesota corporation exempt from income tax under section 501(c)(3) of the internal revenue code (\"irc\") and is not a private foundation as defined by section 509(a) of the irc. Icsi is governed by a board of directors. Ii. Icsi's activities icsi's activities are organized under three arms: mn health collaborative, guidelines and evidence, and dissemination and spread. Mn health collaborative is the collective impact arm of icsi, comprised of major healthcare systems, both care delivery and plans, and other community health care providers. The collaborative determines topic areas, defining scope and implementing changes through multiple working groups, most of them interdisciplinary. Guidelines and evidence: the translation of evidence to practice is a cornerstone of icsi's work. Icsi member authored, evidence-based, guidelines are used nationally and internationally and noted for their implementation guidance. In addition, icsi incorporates evidence reviews into our initiatives, including in mn health collaborative work. All evidence-based documents are made freely available to members and non-members. Dissemination and spread: icsi spreads its evidence work and work of the collaborative using various training and dissemination methods, including echo, webinars and presentations, and training. Covid-19 response activities to prepare and respond to needs during the covid-19 pandemic are open to all healthcare organizations and include: immunizations this working group discusses issues surrounding the sars-cov2 vaccine and other immunizations and included members from care delivery, health plans, mdh, mncm, community health workers, and local public health. Icsi also created a faq to assist providers with up-to-date and evidence-based information on the covid-19 vaccines to support conversations with patients. Mn ehr consortium icsi has been part of the mn ehr consortium since its inception, when a core group of researchers engaged health systems to contribute data so as to develop a surveillance report that included data not available to mdh. 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Mn health collaborative with icsi serving as its backbone organization, the mn health collaborative includes physicians and other representatives from major healthcare organizations working together to address major health topics affecting minnesota communities today including opioid misuse and addiction, system improvements to address broader mental health care needs and building strong networks to address social determinants of health. Health systems in the minnesota health collaborative currently include allina health, centracare health, essentia health, gillette children's specialty healthcare, healthpartners, hennepin healthcare, medica, north memorial health, ridgeview medical center, sanford health, ucare, and united healthcare of minnesota, north dakota and south dakota, and university of minnesota physicians. Opioid prescribing improvement over the course of the past three years icsi convened minnesota surgeons eager to develop a more patient-centered, procedure-specific approach to postoperative opioid prescriptions. The goal was to reduce the risk for addiction among postoperative patients while still providing effective pain management by creating recommendations that could a) reduce the variation among surgeons prescribing for identical procedures and b) provide evidence-based guidance for improving postoperative opioid prescribing practices across many different surgical procedures. Data from healthcare claims across the state of minnesota demonstrate that this work has contributed immensely to safer prescribing practices including: a state-wide 43% decrease in the average postoperative discharge opioid dose between 2016 and 2019. During a four-month cohort effort significant decreases in mme prescribed for orthopedics (-45%), podiatry (-33%) and spine (-52%) surgeries. Along with reducing the risk of addiction, patient experiences were improved by reducing pain and adverse effects of the medication. Culmination of this and other opioid prescribing work related to acute, subacute, postoperative, and chronic pain is published on the icsi website and summarized here: icsi opioid prescribing improvement guide this guide is designed to help individual prescribers build safer opioid prescribing habits. It is also helpful for healthcare organizations as they build systems that support improved opioid prescribing practices for all stages of pain. Development of the guide was funded in part by a grant from dhs, who will offer this guide as one tool to document opioid prescribing quality improvement requirements in 2021. Icsi postoperative opioid prescribing toolkit this toolkit is specifically targeted for supporting prescribers and organizations as they improve postoperative opioid prescribing. It serves as a companion document for the improvement guide. 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