From Seat to Strategy: Embedding Infection Prevention into Organizational Leadership

By Deborah Ellis, PhD, MPH, AL-CIP, CPHQ, FACHE

This article originally appears in the Jan-Feb 2026 issue of Healthcare Hygiene magazine.

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 and quarterly board reports, increasing leadership buy-in and unlocking dedicated resources for prevention initiatives.

Case in Point: Systemic Visibility
One health system recently elevated its senior IP leader to a VP-level role reporting directly to the Chief Quality Officer. This allowed the IP program to participate in strategic planning, lead annual safety initiatives, and influence capital investments in infection-control technologies. The result? A 22 percent decrease in CLABSI rates over two years, faster rollout of antimicrobial stewardship, and stronger Joint Commission readiness.

An example of this model can be seen at Intermountain Health, a not-for-profit health system based in Utah. Their infection prevention leadership reports at the system level and collaborates closely with executive teams across their hospitals and clinics. Intermountain has publicly emphasized the integration of infection prevention in enterprise-level quality improvement initiatives, contributing to high performance on safety scores and regulatory readiness. Their strategic approach, which includes real-time data dashboards and cross-departmental infection prevention councils, exemplifies the proactive model that elevates IP from a compliance task to a leadership role.

This kind of structural visibility turns infection prevention from a reactive service into a proactive leadership asset.

Steps IPs Can Take Now
Even if you’re not yet embedded in your organization’s executive structures, you can start laying the groundwork:
• Retitle your IP Plan – it is more than a department plan, it’s the opportunity to show organizational alignment, it’s your IP Strategic plan, based on real data, population served, and annual performance.
• Map where IP fits in the current org chart, budget, and planning cycles.
• Identify cross-functional opportunities to contribute to strategic conversations (e.g., safety councils, facility design teams, budgeting committees) and insert yourself into those committees.
• Aligning IP goals with strategic priorities such as value-based care, quality incentive programs, workforce or patient experience.
• Engage executive sponsors who can advocate for IP integration at higher levels. These are in addition to your unit sponsors, and physician dyads.
• Develop a multi-year vision for IP that shows how your program supports enterprise goals.

The Future of IP Is Strategic
The healthcare landscape is only growing more complex—financial pressures, workforce shortages, and patient expectations continue to climb. Infection prevention is not a support service in this environment; it’s a stabilizing force.

But only if we’re at the table.

By embedding infection prevention into governance, planning, and metrics, healthcare systems signal that safety isn’t optional—it’s foundational. And IPs, when integrated at this level, become catalysts for resilience, innovation, and strategic success.

We’ve claimed our seat in the room. Now it’s time to shape the agenda.

*Source: Intermountain Healthcare Annual Report (2022); Intermountain Quality and Patient Safety Programs Overview.

Deborah Ellis, PhD, FACHE, is an infection preventionist, healthcare executive strategist, with over two decades of experience driving system-level change in patient safety and organizational performance.