Choosing the Right Staffing Models in Healthcare

January 16, 2023

The healthcare landscape is shifting away from traditional staffing approaches. Nursing shortages, clinician burnout, rising labor costs, and new care models are creating a need for more agile, optimized staffing strategies. By embracing innovative staffing models in healthcare like remote staffing, scheduling automation, and on-demand platforms, leading healthcare systems are driving higher productivity, flexibility, and cost efficiency. One thing is clear – using flexible workforce models is key to advancing organizational performance in today's complex healthcare environment.

An Overview of Staffing Challenges in Healthcare

The healthcare workforce landscape is fraught with challenges that make staffing more complex than ever. Some of the major pressures include:

  • Nursing Shortages: Industry groups forecast a global shortage of registered nurses in the coming years. High rates of nurse turnover, retirements, and burnout exacerbate hiring challenges.
  • Evolving Patient Needs: Patients are older, sicker, and seeking more personalized care, putting strain on staff. The prevalence of chronic conditions that require specialized care is increasing.
  • Changing Care Delivery: Growth in telehealth, retail clinics, value-based care, and precision medicine has begun to change workforce needs and the way that care is delivered to patients.
  • Financial Pressures: Reimbursement shifts, cost control initiatives, and changing payer policies constrain budgets and demand improved labor efficiency.
  • Tech Adoption: New technologies like AI and automation are changing workflow processes and skill requirements.
  • Generational Shifts: Younger staff have different expectations around work-life balance, organizational values, and career development compared to veterans in the field.
  • Regulatory Compliance: Expanding regulatory requirements adds administrative workload for staff.

These converging pressures create a constantly fluctuating demand for various clinical skills and roles. In addition, variability in patient census and acuity across units, seasons, and shifts makes workload difficult to predict. Traditional fixed staffing models may struggle to stay nimble and optimized in the face of these dynamics. That's why new flexible strategies are required.

How New Innovative Models Can Help Lead to Success

Fortunately, a wave of innovative healthcare staffing models have emerged to provide solutions tailored to today's unique staffing challenges. Strategies like enterprise-wide float pools, remote and virtual staffing, algorithm-based scheduling, and on-demand shift platforms can inject much-needed agility, cost efficiency, and talent access.

By embracing new models, healthcare leaders can achieve success through:

  • Greater workforce adaptability and fluidity
  • Technology-enhanced efficiency and decision-making
  • Increased access to specialized clinical skills on demand
  • Data-driven optimization of scheduling and demand planning
  • Cost savings from reduced labor waste and agency staff usage
  • Improved ability to scale and flex with clinical volume variability
  • Higher clinician engagement and retention

With careful change management and continuous improvement, these innovative staffing models can propel healthcare workforce performance to new heights.

The Evolving Healthcare Landscape

The very nature of how healthcare is delivered and enabled by technology is undergoing rapid transformation:

  • Telehealth Adoption: Virtual care models are expanding access but require staff with technical skills. Providers may work remotely.
  • Retail Clinics: Walk-in clinics in retail settings are gaining popularity for convenience but disrupt staffing models.
  • Value-Based Care: Payers incentivize value over volume, demanding improved population health management and preventative health staffing.
  • Precision Medicine: Personalized care based on genetics and data requires specialized staff skills in customized treatments.
  • Artificial Intelligence: AI is automating workflows and enhancing decision-making but requires staff to adapt new tech tools.
  • Wearables and Sensors: Consumer health tech growth means staff may need to manage real-time patient data from devices.
  • Robotics: Robotic tech assists surgeries and care delivery but doesn't replace the human touch needed.

These shifts create a greater need for hybrid staff roles, cross-training, and staffing models that can flex and scale. Agile workforce strategies are essential.

Growing Patient Population with Complex Care Needs

Several demographic and epidemiological trends are converging to increase patient complexity and care needs. The population over 65 is rapidly expanding as life expectancy increases. This older population has substantially higher medical needs and comorbidities. The rise of chronic conditions like obesity, diabetes, cancer, and heart disease necessitates coordinated teams that can provide ongoing care management. Mental health disorders and substance abuse issues are also escalating amidst a nationwide shortage of behavioral care staff.

Longstanding socioeconomic factors continue contributing to disproportionately high rates of preventable chronic disease among underserved populations, raising demands for culturally competent care. Patients across all segments increasingly expect holistic, consumer-centric service experiences, upping expectations for staff capabilities. Collectively, these dynamics are contributing to a swelling prevalence of patients with multiple chronic morbidities who require truly integrated clinical staffing models encompassing a broad spectrum of specialties to provide the best care.

Nursing Shortages and High Turnover

Recruiting and retaining adequate nursing staff has become an increasingly urgent imperative. Several projections forecast the "Great Resignation" trend could catalyze a staffing shortage as demand surges while retirements accelerate among the aging workforce. High levels of burnout and frequent job changes among younger generations lead to turnover that disrupts care continuity. The high-stress nature of nursing contributes to many leaving the profession altogether. Insufficient nursing school capacity also places constraints on expanding the pipeline of new graduates. Proactive strategies to enhance nurse satisfaction, flexibility, developmental opportunities, and workplace culture are critically needed to ensure adequate nursing staff coverage.

Cost Reduction Pressures

Intensifying pressures to control healthcare costs stem from numerous dynamics. The shift towards value-based care and bundled payment models incentivizes reducing waste and inefficiency to improve profitability. High-deductible insurance plans continue to shift costs to consumers, who are demanding more price transparency and lower overall costs. Medicaid expenses are already on an unsustainable trajectory in many states as enrollment grows.

Uncertainty around the future of the Affordable Care Act, potential Medicare and Medicaid cuts, and insufficient reimbursement rate increases from public payers exacerbate financial pressures. With labor representing the largest expense category for most healthcare organizations, optimizing clinical staffing and productivity through innovative workforce models and technology becomes vital in this climate of cost control.

Traditional Healthcare Staffing Models

For decades, most healthcare staffing models have relied upon three primary approaches: full-time employees, per diem staffing, and temporary agency staffing. Each offers certain advantages as well as limitations.

Overview of Traditional Staffing Models Like FTEs, Per Diem, Temporary, etc.

Full-time employees (FTEs) encompass staff who work regular, predictable schedules - often 40 hours per week. Salaries or hourly wages compensate them predictably. FTEs are scheduled in advance by managers to fill recurring staffing needs.

Per diem employees work more variable schedules based on fluctuating demand. They may work a few shifts per month or per week on an as-needed basis. Per diem staff receive hourly pay for the hours worked rather than a guaranteed salary.

Temporary agency staffing involves partnering with external staffing agencies that contract travel and international healthcare professionals, usually nurses, to fill vacancies ranging from a single shift to permanent placement. Agencies manage recruitment and pay.

Full-Time Employees

Full-time staffing delivers stability and continuity of care. Patients see the same regular faces each time they visit. FTEs allow managers to plan schedules weeks or months in advance. In-depth training and professional development investments are made due to their long-term tenure. However, FTE staffing lacks flexibility. It can become costly if patient volumes and facility utilization fluctuate significantly throughout the year. Having to overstaff for peak periods and under-scheduling during lower volume times leads to inefficiency.

Per Diem Employees

Per diem staffing provides useful flexibility to scale up or down based on daily needs. Nurses can be called off or asked to work extra shifts due to census changes. Per diem models work well for departments like the ER where patient volume swings wildly. However, extensive per diem use can lead to less staff cohesion and continuity for patients. Investment in training and growth may be limited. Finding per diem staff willing to work overnight shifts, holidays, or weekends can be challenging.

Temporary Agency Staff

Bringing on temporary agency nurses offers quick solutions to fill gaps from leaves, seasonal fluctuations, or other short-term spikes in demand. Agencies can recruit hard-to-fill specialties in high-need areas like ICU or ER nurses. Orientation may be expedited, and temporary staff may not be familiar with a healthcare facility's culture. Labor costs may fluctuate based on market conditions. However, by partnering with a reputable healthcare staffing agency, these issues can be avoided.

The Pros and Cons of These Traditional Approaches

While traditional staffing models have served healthcare organizations well historically, reliance on just FTEs, per diem staff, and temporary agency nurses has inherent limitations that constrain effectiveness today:

  • FTE staffing lacks nimble flexibility to adjust for fluctuating patient volumes. Significant ramp-up/ramp-down time is required to change levels.
  • Per diem models, while flexible, can present engagement and training challenges for staff who work minimal hours. Finding specialty per diem staff willing to take less desirable shifts proves difficult.
  • None of these traditional approaches provide access to specialized clinical skills on demand when needs suddenly arise.
  • These models make it difficult to leverage innovations like telehealth, remote work, and cross-training without disrupting norms.

Relying solely on legacy approaches today often leaves healthcare leaders frustrated by ongoing staffing inadequacies and inefficiencies.

Why Traditional Models are Proving Inadequate for Many Healthcare Organizations Today

The evolving landscape reveals where traditional workforce strategies can be strengthened to better meet emerging needs. FTE models provide stability yet may lack the agility to swiftly adapt staffing to daily fluctuations and seasonal variability in patient demand. Temporary or contingent agency staff play a vital role in providing urgent access to specialty skills amid pressing needs, which can lead to premium labor costs. Rising patient acuity and care complexity necessitates expanding access to niche skill sets on demand.

Meanwhile, growth in non-traditional care settings like retail clinics, shifting reimbursement policies, and tech innovations all demand workforce agility that legacy models lack. Traditional models fail to provide the scalability, efficiency, or talent flexibility imperative for healthcare facilities today.

Instead, transformative approaches like centralized float pools, remote staffing, scheduling automation, and on-demand platforms are needed. The time has come for healthcare leaders to reinvent staffing models using leading-edge innovations to gain a competitive advantage. Investing in this revolution is now a strategic necessity rather than a luxury.

Emerging Healthcare Staffing Models

In response to the mounting pressures facing traditional workforce models, innovative new staffing strategies are emerging:

Centralized Float Pool Model

Centralized float pools create shared pools of staff like nurses, allied health professionals, or medical assistants who can flexibly “float” between different facilities, departments, and shifts based on real-time demand changes. This delivers proactive flexibility to adjust staffing levels rapidly without relying solely on outside agencies. Some key advantages include:

  • The ability to share staff across service lines avoids silos.
  • Standardized training and protocols enable smooth float transitions.
  • Staff skills and satisfaction improve from cross-training exposure.
  • Costs decrease by reducing external agency use.
  • Engagement increases via workplace variety.

Creating a culture of agility is imperative for success. Robust analytics help optimize float pool scheduling.

Internal Travel/Contingent Nurse Model

Some leading systems are hiring experienced travel nurses for full-time internal contingent roles – also known as internal resource pool management or IRP. These nurses work flexible, customizable schedules spanning multiple sites and specialties. This taps into the specialty skills of career travel nurses within one’s own organization. Benefits include:

  • Increased retention compared to external travel nurses.
  • Eliminates travel nurse onboarding and learning curve.
  • Enables internal temporary staffing without external spending.
  • Provides staffing consistency even as nurses work across settings.
  • Expands benefits access for contingent roles.

Nurses gain staff status, development opportunities, and schedule control.

Remote Staffing Models and Telehealth

Remote telehealth options enable clinical staff like providers, nurses, health coaches, and pharmacists to work from anywhere. Remote staff can perform tele-visits, monitor patients digitally, conduct online chart reviews, manage phone triage lines, and more. Benefits include:

  • Dramatically expands talent pool and access to scarce skills like mental health.
  • Allows site-independent productivity.
  • Reduces campus footprint needs.
  • Enables rapid scaling up or down.
  • Provides staff location flexibility, improving satisfaction.

Does require investments in technical infrastructure, training, and modifying workflows.

On-Demand Digital Staffing Platforms

New digital health platforms are emerging that allow hospitals to instantly submit staffing requests and have qualified nurses or other clinicians ready for needed shifts within hours.  Resource pool management provides talent access with advantages like:

  • Immediately fills unexpected open shifts.
  • Eliminates short-notice staff scramble.
  • Enables temporary staffing without travel nurse overhead.
  • Provides access to specialized skills like OR nurses.
  • Integrates with existing HR systems.

Drawbacks can include onboarding challenges and limited staff familiarity.

Overview of Each Emerging Model and How It Can Benefit Healthcare Staffing

The innovative healthcare workforce models profiled earlier directly address many of the pressing pain points faced by traditional legacy staffing strategies:

Centralized Float Pools

Centralized float pool models provide numerous advantages compared to fragmented staffing approaches:

  • Greatly increase flexibility and agility to adjust RN and other staff levels up or down rapidly based on real-time demand changes. Decrease reliance on external travel nurses for flexibility.
  • Enable smoother staff redeployment across different facilities, specialties, and shifts. Break down silos between departments.
  • Reduce expenses by significantly decreasing reliance on premium-rate external travel nurse agencies to fill gaps. Internal float pools contain costs.
  • Standardized training and care protocols allow float pool staff to adapt quickly across service lines. This helps to smooth transition friction.
  • Provide expanded development opportunities for staff through cross-training. Builds career skills.
  • Increase staff engagement and retention by providing workplace variety and choice.

Internal Travel Nurses

Converting the traditional travel nurse model into an internally or externally managed resource pool provides advantages such as:

  • Increased retention compared to temporary contracted agency nurses. Reduces churn.
  • Decreases expenses and time associated with onboarding new external travel nurses.
  • Provides staffing consistency even as nurses flex across different facilities and shifts.
  • Expands benefits access and career development for these contingent roles.
  • Allows organizations to tap into specialized skills of career travel nurse talent in-house.

Remote Telehealth Staffing

Virtual clinical staffing delivers advantages such as:

  • Dramatically expands talent pool and access to specialized skills like mental health therapy previously constrained by geography.
  • Allows healthcare professionals to be productive on behalf of the organization regardless of physical location.
  • Reduces campus real estate and facility footprint needs.
  • Enables rapid scaling up or down of clinical staff to match evolving patient demand.
  • Provides staff with location flexibility, which aids recruitment and retention.
  • Reduces risk of staff exposure and transmission, especially for infectious diseases.

On-Demand Digital Staffing

Digital on-demand staffing platforms offer additional benefits like:

  • Immediately fill unexpected scheduling gaps with qualified staff within hours rather than days.
  • Eliminate short-notice scramble to find available clinicians such as after a sick call.
  • Provide access to hard-to-find skills like ICU or OR nurses on-demand rather than waiting on contracts.
  • Enable temporary staffing needs but with lower overhead than external travel nurses.
  • Integrate robust data analytics on staff utilization, skills, and costs.

Together these emerging approaches provide healthcare organizations with the agility, flexibility, cost efficiency, and talent access needed to overcome legacy staffing limitations and optimize the workforce.

Best Practices for Implementing New Staffing Models

Beyond just acquiring new technology, effectively implementing and optimizing next-generation staffing strategies requires leadership, communication, training, and integration.

Leadership Buy-In and Culture Change

Gaining alignment, support, and active sponsorship from executive leaders and nursing management is imperative to drive the adoption of any transformative new nurse staffing approaches. Nurse leaders must directly champion changes, communicate the vision and rationale, and address any objections. Providing data modeling potential efficiency gains, cost savings, and care improvements can help overcome resistance.

Developing an organizational culture that values flexibility, innovation, data-driven decisions, and staff engagement will enable success. Traditional rigid hierarchies must evolve. Organizations should foster a spirit of openness to new workforce models. Leaders should participate visibly in planning and celebrating wins.

Communication and Change Management

Frequent, transparent communication coupled with thoughtful change management processes will ease the transition to new nurse staffing models. Town halls explaining changes, online FAQs, feedback mechanisms, and including staff in planning all build engagement.

Healthcare organizations should provide opportunities for nurses from all levels to actively participate in model design and share input. Involve frontline staff in identifying pain points.

Training and Development

Organizations should allocate dedicated resources for training programs upskilling nurses on any technologies or processes foundational to new models. For example, provide virtual care training for telehealth nursing models. One major aspect of ongoing training and development is to build data literacy for staff to work with new analytics systems. In turn, this can help strengthen change management capabilities for leaders.

Additional steps for training and development include:

  • Cultivate a growth mindset around continual learning.
  • Make training dynamic and interactive using simulations.
  • Create online training repositories allowing self-paced learning.
  • Recognize nurse certifications.

Using Data and Analytics for Continuous Optimization

Healthcare organizations need to leverage quantifiable KPIs around cost savings, turnover, vacancy rates, patient satisfaction, quality metrics, and other data points to continually optimize new nurse staffing approaches over time. Robust analytics enable data-driven improvements versus gut decisions.

Integrating New Models into Back-End Systems

Organizations should ensure critical back-end HR infrastructure like payroll, learning management systems, budget planning tools, and other enterprise platforms integrate smoothly with any new scheduling systems, telehealth technologies, or on-demand staffing applications.

Be sure to prioritize seamless interoperability and real-time data flows across platforms so all systems maintain synchronized data. Offer training classes on new technologies for HR analysts supporting the platforms and monitor integration issues.

Predictions for How Staffing Models May Evolve Moving Forward

Many workforce experts foresee the future of healthcare staffing evolving towards even more fluid, agile, personalized, and technology-driven models. There will likely be an expansion of on-demand digital shift marketplaces that allow instant access to find and fill needed skills among vast talent pools, accelerating the shift towards more flexible, temporary "gig economy" staffing. An increasing number of clinical roles like telehealth providers and remote patient monitors will completely separate work from physical facilities.

Emerging technologies like virtual reality, AI chatbots, and ridesharing platforms will enable smoother onboarding, training, and deployment of both remote and on-site staff. Tighter real-time integration will emerge between underlying HR systems, automated scheduling tools, skills databases, and advanced workforce analytics engines to enable robust forecasting, optimal efficiency, and precision staffing at scale. Customized shift patterns will allow staff greater control over their own schedules to improve work-life balance, with more self-scheduling autonomy arising. Healthcare staffing will only grow more mobile, adaptable, and personalized in the future.

The Role of Technology and AI

There is no question that artificial intelligence, predictive analytics, and automation will transform healthcare staffing processes and productivity. However, human judgment, clinical expertise, and compassion will remain at the center guiding technology to enhance human capabilities rather than replace them outright. The right balance is key.

The Importance of Flexibility and Agility

The only constant across healthcare is accelerating change. New care delivery models, patient expectations, technology disruptions, regulations, and cost pressures guarantee ongoing shifts. Therefore, all facets of healthcare operations, including staffing, must themselves be nimble and adaptable enough to continually evolve. Staffing innovation cannot stop. Agility is mandatory for success.

By taking a future-forward outlook today, health systems can get ahead of trends and proactively build the optimized but flexible workforce necessary to deliver outstanding patient care through inevitable industry transformations ahead.

Key Takeaways

Forward-thinking staffing models like enterprise float pools, remote staffing, on-demand platforms, and algorithm-driven systems clearly lead to success. When combined with savvy change management and continuous optimization, these models provide the agility, efficiency, and talent access needed to address today's healthcare staffing challenges.

Why Today's Healthcare Organizations Should Evaluate Their Staffing Models

The time is now for healthcare leaders to take a close look at their existing staffing models and assess where more agile, innovative approaches can drive value. Consider how leveraging new technologies and more flexible roles could benefit your organization. Partner with expert recruiters like Health Carousel who can help make the transition to next-generation staffing models smooth and successful.

Healthcare Staffing Solutions from Health Carousel

Developing optimized staffing strategies is more crucial than ever for healthcare facilities striving to deliver excellent patient care in an environment of nursing shortages, growing talent scarcity, and increasing cost pressures. Health Carousel offers innovative workforce solutions that enable healthcare organizations to implement many of the next-generation staffing models.

Specialized Talent Access

Through Health Carousel’s global recruiting expertise, healthcare organizations gain access to a wider pool of travel and international nurses who can help fill critical nursing gaps after thorough vetting. Our national network of experienced travel nurses provides short-term coverage and flexibility for a fluctuating census. International nurses and provide long-term workforce stabilization. And we source hard-to-find allied health professionals across specialties like rehabilitation therapists, imaging techs, pharmacists, and more.

Advisory Services

Beyond just talent access, our team serves as trusted advisors, helping clients assess their current staffing models. We identify opportunities to adopt emerging approaches like centralized float pools, remote staffing, scheduling automation, and more. Our experts become partners in the transformation of your healthcare organization.

Data-Driven Optimization

We pair best-in-class digital tools for tracking granular staffing metrics and insights with high-touch personalized service. This enables data-driven optimization of workforce strategies over time.

Innovation Focus

By combining access to specialized talent, flexible staffing solutions, and data-driven advisory service, Health Carousel delivers exactly the type of forward-thinking staffing capabilities healthcare organizations need to prepare for the future. Our solutions enable success through optimized, agile staffing strategies.

If our solutions sound like the right one for you, request our staffing services today.


What are the main benefits of a float pool model in healthcare staffing?

A float pool model in healthcare staffing refers to having a pool of staff such as nurses or allied health professionals that can move flexibly between departments and units as needed. Some of the main benefits of using a float pool include improved staffing flexibility, better coverage for staffing shortages, reduced costs associated with overtime, improved staff satisfaction, and enhanced skill development for the float pool nurses. The model allows healthcare organizations to move staff to areas experiencing higher patient volumes or staff shortages more efficiently. The float pool nurses also enjoy the variety and exposure to different specialties. Overall, a float pool model in healthcare staffing allows for better workload distribution and a more nimble approach to managing staffing needs and responding to fluctuations in patient volumes and acuity.

How can I implement a remote healthcare staffing model?

Implementing a remote healthcare staffing model requires careful planning and coordination. The first step is to evaluate which roles and specialties can effectively be staffed remotely versus requiring in-person care. For positions suited for remote work, such as telehealth nurses or coders, ensure staff have the technology, training, and protocols to provide quality care and meet legal compliance virtually. Create schedules that blend remote and on-site staff to maintain coverage and continuity of care. Provide remote staff opportunities to connect with the broader care team through video conferences, messaging, and periodic in-person meetings or events. Monitor productivity and patient satisfaction metrics to ensure the remote model is working effectively. With proper implementation focused on communication, technology, training, and blending remote and on-site staffing, healthcare organizations can build an effective remote staffing approach to expand access to care.

What should I look for in healthcare staffing software?

When evaluating healthcare staffing software, it's important to consider features that will streamline your recruiting, onboarding, scheduling, and employee management processes. Look for a user-friendly interface, customizable dashboards, and robust reporting capabilities. The system should integrate with your existing HR platforms and provide mobile access for on-the-go managers and employees. Key factors to consider include candidate sourcing and tracking, automated shift management, compliance tracking, and robust communication tools. Prioritize solutions that allow customization to your organization's specific needs and workflows.. Selecting software that grows with your business and has a reputation for excellent ongoing customer support is ideal for long-term value.

About Health Carousel

Health Carousel is committed to partnering with world-class healthcare facilities across the country, providing rewarding assignments for Registered Nurses and Allied Health Professionals, and attracting the best internal talent at all career levels.