Insertion sequence (IS) elements are powerful but underappreciated drivers of genomic diversification in bacteria. My research investigates the role of IS elements as drivers of micro and macro-evolution in staphylococci, and how this shapes their adaptation to healthcare environments. Drawing on over five years of bacterial genomics and bioinformatic expertise in industry, my work so far has demonstrated that IS elements are highly active during within-host evolution of Staphylococcus epidermidis in orthopaedic device-related infections. Future work will focus on more broadly characterising IS element dynamics within healthcare-associated lineages of staphylococci.