Training for Antimicrobial Resistance to Transform Health Services

Embedding antimicrobial resistance management in routine care demands cross-disciplinary skills, change management and interoperable IT. GDPR and legacy systems hinder integration of point-of-care tools such as RaDAR. Progress relies on shifting from silos to process-based teams and sustaining training with leadership support. Priorities include stepwise, evidence-backed adoption and a 2030 vision built on EU data spaces for early detection and cross-sector stewardship.

Key Points

• Cross-disciplinary skills are essential for AMR in routine care.
• GDPR and legacy IT block real-time integration of point-of-care tools.
• Hospitals must shift from silos to process-based teams.
• Ongoing training needs leadership support and change management.
• Adoption should be stepwise and evidence-based, in line with EU data spaces.

Maddalena Illario, Endocrinologist and Associate Professor at Federico II University of Naples, coordinates the Campania Reference Site of the European Innovation Partnership on Active and Healthy Living. A former coordinator of Campania’s Health Innovation Division, she is chair of the Reference Site Collaborative Network and contributes to cross-disciplinary training on antimicrobial resistance.

During a 2025 EHTEL Imagining 2029 work programme session, “The Digital Transformation Journey: Creating a digitally confident health and care workforce,” Illario shared insights on how the hospital is preparing a future-ready workforce, including experience from the RaDAR project. Staff are focusing on leadership, point-of-care teamwork, collaboration and digital development (EHTEL 2025a). She also offered complementary insights into lessons learned on digital transformation at the EHTEL 2024 Symposium (EHTEL 2024a, b). Both sessions were supported by the Erasmus+ BeWell project (EHTEL 2025b).

Lessons from AMR Training

Q. What were the most significant lessons learned from implementing cross-disciplinary AMR training? How can these findings be scaled?

A. Cross-disciplinary training involves the challenge of engaging a variety of health and care (and other) professionals. While all the staff have hands-on experience in daily practice, they need to handle a different part of the patient journey when a case of AMR emerges.

Viewing AMR management as a process of interconnected activities facilitates reciprocal awareness of roles and responsibilities. At the same time, it sharpens the focus on specific elements of training topics and skills.

For scaling AMR training, similar interactive training sessions should be tailored to the specific needs, protocols and resources of each hospital or clinic. This includes adjusting content to reflect local infection control procedures, staff roles and IT infrastructure.

Q. What have been the main barriers and enablers in integrating point-of-care technologies, such as RaDAR, into routine hospital workflows?

A. Hospital workflows are supported by systems that are almost not interoperable with new modules, although, in theory, some improvements are foreseen in supplier contracts. This lack of interoperability locks in the entire hospital IT architecture, making it unfriendly to innovation, resistant to change and unable to take advantage of new tools that might otherwise be accessible, especially in university hospitals that integrate research, training and service provision.

Key barriers included the inability to integrate RaDAR in real time with health information systems due to hospital IT upgrades.

The General Data Protection Regulation (GDPR) restricts the hospital’s ability to test new platforms, as hospital data cannot be moved outside the information system. This lack of data mobility worsens the innovation scenario and makes integration with new modules, platforms and tools difficult.

The main enablers for integrating RaDAR into routine workflows included a structured change-management plan, effective training, strong stakeholder engagement and successful technical installation.

From Research to Sustained Practice

Q. You describe a shift from a functional to a process-oriented hospital structure. What organisational adaptations were most critical in enabling this transformation?

A. The shift from functional to process is a major change and will take time. Resistance is driven by organisational culture built around professional roles rather than team building and value-added improvements.

The silos created by different scientific disciplinary sectors further hinder interdisciplinary results that could improve service processes, system sustainability and health outcomes.

To accelerate transformation, there is a need for top-down activation that changes how performance is assessed and incentives are applied across the whole process. It is important to account for service processes that still acknowledge different scientific and professional roles, but workflows must be reorganised to strengthen horizontal activities across the hospital.

Q. You mentioned a persistent gap between research outcomes and real-world service provision. What practical strategies have helped to close this gap in your work, and what still needs to be addressed?

A. We have applied several practical strategies and still face some outstanding challenges.

Engagement of all stakeholders involved in the process, regardless of their roles and levels, has helped identify pain points and untapped resources that could accelerate transformation, such as human resources and calls for funding. Co-creation of training, involving all stakeholders in a peer-to-peer approach to knowledge exchange, has also been stimulating for the hospital team.

Weak engagement of top management remains to be addressed, as there is still no clear prioritisation at policy level of the efforts needed to integrate innovation, or of the innovations available and their impacts. The constant focus on short-term priorities linked to political timeframes and associated appointments to top management roles negatively influences the medium- to long-term planning needed to ensure exploitation, sustainability and full impact. Strengthening the planning role of permanent middle-management positions may help ensure continuity of relevant activities during political shifts.

Q. How do you ensure that training in digital tools is not just a one-off event but leads to sustained changes in clinical decision-making and interprofessional collaboration?

A. The ability to ensure medium- and long-term planning for training and innovation, in a way that is flexible and up to date, mitigates resistance to change. It strengthens confidence in digital solutions and technological innovations, especially when nurtured in a collaborative, team-based approach. This approach also helps build a sense of purpose and belonging that benefits productivity and service quality.

Building the AMR Ecosystem for 2030

Q. What are your priorities for making innovations in AMR management sustainable, both financially and operationally, within regional and national health systems?

A. Our influence on regional and national health systems may be limited. We can, however, ensure that our efforts generate evidence that the tested innovations are effective. The system can then be implemented stepwise, supported by customised training. Disseminating results to other interested networks and communities, such as the EU Health Policy Platform (HPP) and the Transforming Health and Care Systems (THCS) Partnership, is well within our reach.

Q. What would a fully digital, integrated and resilient AMR management ecosystem look like in 2030?

A. Such an ecosystem would build on the common European open data space to ensure that data can follow citizens. This would strengthen AMR monitoring and enable stewardship adapted to the local AMR profile. It would also support early detection of AMR through point-of-care testing to prevent further transmission across microbes. Integrated point-of-care testing would help monitor hotspots for AMR, such as hospitals, nursing homes and prisons.

The European data space would also support data sharing across health, agriculture, and veterinary sectors to enable coherent and complementary policies and actions.

Conflict of interest

None.