Table 3 Identified themes and illustrative quotations

T1- Streamlining and decompartmentalizing IPC and AMS activities

Related codes: Planning, implementation facilitators, CRATB strengths, interaction facilitators

Subtheme: shared human and material resources

Q1: "But actually we [CRATB and IPC coordinating center] have our offices in the same place. We have our offices, really close together. So it’s pretty easy to interact.” CRATB coordinator (Region 4)

Q2: “We have the same offices, we have shared staff, shared secretarial support, we have a shared practitioner because we have a practitioner who is half-time [IPC coordinating center], half-time [CRATB]." IPC coordinating center coordinator (Region 1)

Q3: "That is to say, she [the CRATB research engineer] has two positions. 80% on the [IPC coordinating center] mission and 20% on the CRATB. But it isn’t a person who is within one entity who’s made available for the other. And the secretary is the same. The secretary is a full-time employee of the [IPC coordinating center] who, on an ad hoc basis, provides assistance to the CRATB. For example, for mailings, sending out documents. Things like that, providing mailing lists for emails, for communication.” IPC coordinating center coordinator (Region 3)

Q4: "So we have the mailing lists, we have [IPC coordinating center] data and data from other missions on [AMR] that are, that go through the [IPC coordinating center] and that are sent to the CRATB, for example." IPC coordinating center coordinator (Region 3)

Subtheme: Effective collaboration

Q5: "And so I think that the [locally operating IPC consultant teams], when they are set up, and the [locally operating AMS consultant teams], will have every interest in working together since... it won’t always be the same actors, but still Infectious Disease Specialists, coordinating physicians, GPs, pharmacists, and GPs. Nurses eventually as well. So it is in our interest to work together to intervene in nursing homes and make things evolve in terms of [AMS] and infection prevention. So we have everything to gain by working together" CRATB coordinator (Region 1)

Q6: "We are really, sincerely, the key words, it’s really to decompartmentalize. We’re trying to decompartmentalize and to mutually call upon each other as soon as we do workshops, as soon as... even if they are fields that, a priori, do not directly concern either the [IPC coordinating center] or the CRATB." IPC coordinating center coordinator (Region 4)

Q7: "We have [X number] of mobile [IPC] teams that cover the region and it’s clear that we need to ensure that they fit into this organizational chart for [AMS]. They are all quite enthusiastic about it, most of them are very, very keen on activities to promote [AMS] in nursing homes, which will probably be the key interface to reach the liberal sector.” IPC coordinating center coordinator 2 (Region 5)

Q8: "Well, there are two circles. There’s the [IPC coordinating center] agenda and the CRATB agenda. There’s a common core to both actually. They connect on parts of their agendas." Regional Health Agency officer (Region 4)

Q9: "Or when there’s a problem, for example, when we’re asked to give advice. This happens to me from time to time in nursing homes. As soon as the situation drifts towards treatment, curative care, we hand over to the Infectious Disease Specialist... We hand over to the Infectious Disease Specialist because each of us has our own area of expertise. And that’s it. I regularly call on our colleagues here [Hospital in city X], who are the [locally operating AMS consultant team], for advice on antibiotic therapy. That’s pretty comfortable, actually." IPC coordinating center coordinator (Region 3)

T2- Engaging with liberal health professions

Related codes: Engaging, implementation barriers, CRATB strengths, CRATB weaknesses, interaction facilitators, interaction barriers

Subtheme: Hiring GPs for CRATBs and locally operating AMS consultant teams

Q1: "It was a hurdle [hiring a GP] for several months. Clearly, I spent a lot of time on it. It took... I contacted over a hundred GPs myself by getting them on the phone. Contacted them by email." CRATB coordinator (Region 4)

Q2: "I And do you have any idea why it was difficult to motivate GPs to join this type of structure?

P Perhaps first of all, as the GP contact network wasn’t extremely complete, at least as far as I was concerned, perhaps the information wasn’t circulated enough. And then, we have funding for a part-time GP. With the budget we had at the beginning, which was miserable, we had no chance of being able to convince a GP to join us part-time with the pay we were going to offer him. It took two months to be able to get a salary increase. It’s just hard to recruit a part-time GP like that.” CRATB coordinator 1 (Region 5)

Subtheme: Communication and reach towards liberal professions

Q3: "It’s true that if we can’t find a GP, if we can’t reach them, if... there’ s perhaps a point... The weakness is perhaps a difficulty in reaching the liberal world. By its [the CRATB] organization, already, from the outset by its organization in particular, carried by a university hospital, that’s perhaps its weakness.” CRATB coordinator (Region 7)

Q4: "So, in order to have an impact on [primary care], it will be really interesting. In addition to having three [GP] colleagues who can help us... who can think and help us reach out to that sector." CRATB coordinator 1 (Region 3)

Q5: "And our second hope is really to have a tool to act on [primary care] and to collaborate a little bit better with [the primary care sector]. We have a link, we have this hotline, so we’ve had a fan club of GPs for a long time. But on the other hand, we don’t reach, or with great difficulty, a large part of GPs who don’t ask for advice and work alone. Now I have hope that this will give us tools.” CRATB coordinator 2 (Region 5)

Q6: "Where we have, I find, we have a lot of... a lot of room for improvement, is with respect to [primary care], [primary care] prescriptions. And that we haven’t tackled because we have… it’s difficult to reach them directly. We have to go through the [Regional Union of Health Professionals]. And then, if we don’t have specific information, we never get the mailing lists so we have to give them the information. And then if it works... Well, it’s then distributed to all the liberal physicians, but if not, we can’t." IPC coordinating center officer 1 (Region 5)

Q7: "I don’t know how many thousands of GPs we have in [Region 3]. We don’t have an easy entry point. It’s very complicated. [...] Through the COVID crisis, we had some connections with [primary care], but I won’t lie to you, it’s not great, the [primary care sector]. Why isn’t it great? Because actually, the entry points are complex [...]." IPC coordinating center coordinator (Region 1)

T3- Role of pre-existing networks and working relationships

Related codes: Planning, relationships, engaging, implementation facilitators, implementation barriers, CRATB strengths, interaction facilitators

Q1: "Because in [Region 2] we can almost say that the CRATB has existed informally for 10 years. What I mean is that we are really in contact with many stakeholders from different catchment areas and different specialties. So there is a certain organization that’s already there.” CRATB coordinator (Region 2)

Q2: "Well, its strengths, as I said earlier, is having existing resources, practitioners and... who know each other, local actors who have already worked together and projects that have already been developed and are running, particularly in terms of training. That, I think, is one of our great assets.” CRATB coordinator 1 (Region 3)

Q3: "The strong points I think is the history, since [the previous AMS structure] exists since 2003. So recognized for a while. I mean [the AMS network] is a network that is starting to be known in the region. So it gives some weight. And then the doctors call for telephone advice. They come for conferences, consult the website even if it’s not... It could be better. But, so... There is still a history, a recognition at the regional level, collaborations with many infectious disease services and structures in the region.” CRATB coordinator (Region 1)

Subtheme: Continuity of relationships and actions

Q4: "Because now, we’re thinking that the CRATB will promote a lot of the actions that we were carrying out before with [the previous AMS structure] in order to get our foot in the door.” CRATB coordinator (Region 8)

Q5: "We have to build our regional organization in relation to the previous one. We’re not going to say, let’s just sweep up everything and start over and... that’s pointless." Regional Health Agency officer (Region 4)

Q6: "The CRATB is being established. And we change nothing. In fact, we are continuing the actions that are already in place. We will, we will, we won’t change anything, we’ll continue these actions and we’ll especially develop new ones because we’re better structured.” CRATB coordinator 2 (Region 3)