infection prevention
infection prevention
By Deborah Ellis, PhD, MPH, AL-CIP, CPHQ, FACHE
From Seat to Strategy: Embedding Infection Prevention into Organizational Leadership
Early in my career as an infection preventionist( IP), I remember feeling a deep frustration. Despite writing policies, conducting audits, leading training sessions, influencing workflows, and creating strategy, I often saw implementation fall apart or worse, never taking hold at all. The decisions that shaped our infection prevention efforts were often made elsewhere; in rooms I wasn’ t invited into. I didn’ t have language for the problem until one night, sitting in a theater watching the stage play“ Hamilton.” When the cast broke into the song“ The Room Where It Happens,” something clicked: That’ s the problem. I need to be in the room where it happens. That moment shifted my career trajectory— and my perspective on what it really means to lead infection prevention.
IPs have fought hard to be heard by healthcare leadership. We’ ve demonstrated our value during crises, many have learned to speak the language of the C-suite, and we have framed our initiatives in strategic, financial, and operational terms. But influence is only the beginning.
The next evolution for infection prevention is integration. Not just being consulted on policy but shaping it. Not just reacting to outbreaks but helping design systems that prevent them in the first place. It’ s time for IPs to move from advocates to architects of organizational strategy.
Why Integration Matters
True integration of infection prevention into healthcare leadership ensures that safety is not just an initiative but it’ s a core operating principle. When IPs are embedded into the planning, budgeting, and governance processes, infection prevention becomes proactive, not reactive. This shift drives stronger patient outcomes, operational resilience, and financial performance.
Healthcare systems that wait to involve IPs until after a problem arises, or as part of survey readiness, are inherently less prepared. The systems that lead in safety, efficiency, and compliance bring infection prevention to the table early— during design, decision-making, and strategy setting.
Three Pillars of Strategic Integration To embed infection prevention into the DNA of a healthcare organization, IPs must operate across three critical pillars: 1. Governance and Leadership Strategic integration starts with where IPs sit in the organization. Do IP leaders report into nursing, quality, or clinical operations, or do they have a direct line to enterprise-level leadership? The closer IPs are to decision-makers, the more likely infection prevention is to be represented in board-level strategy.
IPs should serve on safety and quality councils, enterprise risk committees, and even strategic planning task forces. Regular presence in these venues elevates IP from compliance oversight to
risk mitigation and value creation.
In my own experience, serving on system safety and quality councils allowed me to directly influence annual strategic goals, such as reducing central line-associated bloodstream infection( CLABSI) rates and implementing an enterprise-wide prevention of surgical site infections initiative. Because of our early involvement, we aligned infection prevention priorities with broader organizational objectives, which resulted in measurable reductions in hospital-acquired infections within one fiscal year. 2. Resource and Capital Planning Embedding IP into capital and operational planning ensures infection risks are considered before projects launch, not after problems arise. Pre-Infection Prevention Risk Assessments( P-ICRA) are even more important than Infection Control Risk Assessments( ICRAs), that start right before the project launch. Whether designing a new facility, investing in sterilization equipment, or evaluating staffing models, infection prevention should be a co-author of the resource conversation.
Proactive IP input can reduce future costs, avoid redesigns, and accelerate compliance readiness. Systems that include IPs in budget cycles also send a strong message: infection prevention is not overhead— it’ s essential infrastructure.
When an organization that I worked at planned the construction of a new space for their dental clinic’ s relocation, I advocated for infection prevention involvement from the blueprint phase. This allowed us to make key decisions, such as airflow design, surface materials, sterilization reprocessing workflows, and location of hand hygiene sinks, that prevented costly post-construction fixes. Working closely with the construction company, and regulatory, ensured that the center passed infection control inspections once the project was complete, and an initial inspection survey to obtain operational license proceeded smoothly. 3. Data, Metrics, and Dashboards C-suite leaders rely on performance dashboards to guide decisions. Infection prevention metrics must be integrated into these systems. That means aligning IP data with organizational KPIs such as safety scores, readmission rates, length of stay, and reputational benchmarks.
It also means shifting from raw infection counts to strategic indicators: cost avoidance, HAI prevention ROI, or risk-adjusted safety gains. When infection revention metrics appear alongside financial, patient experience, and operational data, infection prevention becomes part of the enterprise narrative.
At one hospital where I led the IP team, we collaborated with the quality department and the board to build infection metrics into the executive performance dashboard. For the first time, we linked our HAI reduction efforts to cost avoidance projections. As a result, IP outcomes began showing up on monthly operations
8 • www. healthcarehygienemagazine. com • jan-feb 2026