Strategic Framework for addressing Antimicrobial Resistance: Governance Practices and Innovation in Teaching Hospitals

Introduction : Antimicrobial resistance (AMR) is the ability of microorganisms to become resistant to drugs. This resistance is a global health threat due to multifactorial factors not only in humans, but also in animals and agricultural production. The justification for the present study is related to the theme as a global health emergency in the face of the impacts of the pandemic, and the need to better understand the complex relationships between hospital governance and the fight against AMR in teaching hospitals. The objective, therefore, is to propose an empirical model on governance practices and innovations in addressing AMR. Methods The Convergent Care Research (CCR) method was employed, utilizing a qualitative approach with triangulation of sequentially conducted studies: a) documentary analysis, b) scoping review, and c) semi-structured interviews. The study was conducted in a large teaching hospital within Brazil's Unified Health System (SUS) in the Triângulo Mineiro region in 2023. Results Through the triangulation of all proposed studies, it was possible to establish an empirical theoretical model that indicates that practices related to responsiveness, evidence-based practices, and innovations, as well as hospital practices and routines, are the outputs, products, and tools proposed for addressing AMR in the researched hospital. Conclusions No similar proposal was identified in the literature. This is a unique proposal, the first in Latin America to strengthen the governance of public teaching hospitals in addressing AMR. It is expected that, when applying the model to public teaching hospitals, given the combination of the three practices presented—focusing on staff training and development, active surveillance and audits, and diagnostic innovation and strengthening hospital routines—controls (sensitive monitoring indicators) will signal a decline in infection rates.