title: Addressing healthcare-associated infections and antimicrobial resistance from an organizational perspective: progress and challenges.
abstract: This paper explores the progress and challenges associated with the application of organizational factors and approaches to infection prevention and control (IPC) and antibiotic stewardship (AS) in England, many of which have been considered and supported by the Advisory Committee on Antimicrobial Resistance and Healthcare-associated Infections (ARHAI). An organizational perspective is described and the wider macro context and socio-political forces that shape an organizational approach are considered. Factors that drive organizational change in IPC and AS are discussed. The tensions, constraints and dilemmas that can occur are identified and outstanding challenges are debated. Some recommendations for the future direction of IPC and AS organizationally focused strategies and research are proposed.
authors.affiliation: Imperial College Centre for Patient Safety and Service Quality, Faculty of Medicine, Imperial College London, 5th floor Medical School Building, St Mary's Campus, Norfolk Place, London W2 1PG, UK. e.murray@imperial.ac.uk
authors.forename: Eleanor
authors.initials: E
authors.lastname: Murray
authors.forename: Alison
authors.initials: A
authors.lastname: Holmes
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D001424:Bacterial Infections / Q000382:microbiology / Q000517:prevention & control; D016360:Clostridioides difficile / Q000472:pathogenicity; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control*; D003695:Delivery of Health Care / Q000191:economics / Q000379:methods / Q000458:organization & administration*; D024881:Drug Resistance, Bacterial; D004739:England; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000472:pathogenicity; D011787:Quality of Health Care / Q000458:organization & administration*
chemical_list: D000900:Anti-Bacterial Agents