Nurse uses flexible staffing model to pick up shift.

The importance of staffing flexibility in healthcare cannot be overstated. As the demand for healthcare services fluctuates, hospitals must adapt swiftly to maintain high standards of patient care while ensuring staff well-being. The recent shift towards more flexible staffing models has proven to be a vital strategy for managing these dynamics effectively. This guide aims to provide hospital leadership with an in-depth understanding of various staffing flexibility models. 

Staffing flexibility models encompass a range of strategies to meet the dynamic needs of healthcare facilities. For instance, a hospital might use a float pool to manage sudden spikes in patient volume or a per diem staffing model to cover for staff on leave. Each type of staffing flexibility offers unique advantages and potential challenges of staffing flexibility. By exploring these models, organizational leadership can make informed decisions to optimize their workforce and enhance operational efficiency. 

The Need for Staffing Flexibility 

The healthcare industry is facing an unprecedented staffing crisis, with a significant shortage of nurses and other healthcare professionals. Traditional staffing methods, often rigid and slow to adapt to changing needs, are increasingly proving inadequate. This has led to heightened turnover rates, increased burnout among staff, and escalating labor costs due to the reliance on expensive travel nurses and other contingent labor. 

During a recent AONL webinar titled “Unlock Nursing Operational Success with Flexible Staffing,” industry experts discussed the urgency of addressing these staffing challenges and the role of flexible staffing models. Jessica Potts, the System Senior Director of Strategic Workforce Operations at SSM Health, and Jay Simer, Chief Nurse at Presbyterian Healthcare, shared their experiences and success stories in implementing on demand staffing solutions. 

Implementing on demand flexible staffing model at SSM Health

Staffing Flexibility Models in Healthcare Organizations 

Float Pools 

Float pools consist of a group of healthcare professionals who are cross-trained to work in various departments as needed. These staff members are not assigned to a specific unit but can float across multiple areas based on real-time demand changes. This model allows hospitals to adjust staffing levels quickly without relying solely on external agencies. Float pools provide flexibility, enabling healthcare facilities to manage unexpected patient volume surges and staff absences efficiently. 


  • Flexibility in Staff Allocation: Float pools enable hospitals to allocate staff where they are needed, addressing sudden increases in patient volume without permanent hires. 

  • Cost-Efficiency: By utilizing existing staff more efficiently, hospitals can reduce the need for costly agency nurses or overtime pay. 


  • Maintaining Skill Levels: Ensuring that float pool staff maintain proficiency in multiple areas can be challenging and requires ongoing training. 

  • Scheduling Complexities: Coordinating schedules for float pool staff to ensure coverage across departments can be complex and time-consuming. 

Per Diem Staffing 

Per diem staffing involves hiring healthcare professionals on an as-needed basis. These staff members work on short-term contracts, filling in for regular employees who are absent or during peak times. Per diem staff provides hospitals with the flexibility to address staffing shortages and fluctuations in patient volume quickly. They are typically employed on a day-to-day basis, allowing healthcare facilities to cover shifts without long-term commitments. This ensures patient care standards are met despite variable staffing needs.  


  • On-Demand Staffing: Per diem staff provide a flexible solution for covering unexpected absences or spikes in patient volume. 

  • Flexibility in Shift Coverage: Hospitals can quickly adjust staffing levels based on current needs without long-term commitments. 


  • Higher Cost Per Hour: Per diem staff often command higher hourly rates compared to full-time employees. 

  • Limited Availability: The availability of per diem staff can be unpredictable, potentially leaving gaps in coverage during critical times. 

Contract Staffing 

Contract staffing involves hiring healthcare professionals for fixed-term contracts, typically arranged through staffing agencies. These contracts can range from a few weeks to several months. Contract staff are brought in to fulfill specific needs, such as covering for long-term absences, managing seasonal patient volume increases, or providing specialized skills for particular projects. This model offers a stable workforce for the duration of the contract, ensuring continuity of care and allowing hospitals to address immediate staffing shortages. 


  • Long-term Stability: Contract staff provide a stable workforce for extended periods, ensuring continuity of care. 

  • Specialized Skill Sets: Contracts allow hospitals to bring in specialized professionals for specific needs or projects. 


  • Higher Cost for Extended Periods: While effective for short-term needs, extended contracts can become costly. 

  • Dependency on External Agencies: Relying on staffing agencies can lead to dependency, reducing internal control over staffing. 

Temporary Staffing 

Temporary staffing involves hiring healthcare professionals on a short-term basis, often through staffing agencies, to meet immediate needs. These professionals are employed to cover staff absences, manage sudden increases in patient volume, or address seasonal demands. Temporary staff can include nurses, physicians, and allied health professionals who are available to step in at short notice, providing flexibility and ensuring continuous patient care. This model helps hospitals avoid understaffing during critical times while reducing the administrative burden associated with recruiting and onboarding permanent staff.  


  • Immediate Staffing Solutions: Temporary staff can quickly fill gaps, ensuring patient care is not compromised. 

  • Reduced Administrative Burden: Agencies handle recruitment, reducing the administrative workload for hospitals. 


  • Lack of Continuity in Patient Care: Frequent changes in temporary staff can disrupt continuity of care and affect patient outcomes. 

  • Potential Quality Concerns: Ensuring the quality and consistency of care provided by temporary staff can be challenging. 

Choosing the Right Model 

When choosing the right staffing flexibility model for your healthcare facility, several factors must be taken into account to ensure the model aligns with your operational needs and goals: 

  • Budget Constraints: Evaluate the cost implications of each model to ensure financial sustainability. Each model has different cost implications; for example, per diem staffing might have higher hourly costs but offers the flexibility to avoid long-term commitments. 

  • Staffing Needs and Volume: Assess current and projected staffing needs to determine the most suitable model. Facilities with fluctuating patient volumes benefit from temporary or float pool staffing, which allows for quick adjustments based on real-time demands. 

  • Specialized Skill Requirements: Consider the specific skills required and how each model can meet these needs. Contract staffing, for example, can be particularly useful for bringing in specialized skills that are not available within the existing staff, ensuring that patient care standards are maintained during critical times​​. 

 ShiftMed: A Flexible Staffing Solution  

Given the diverse needs of healthcare facilities, an approach that considers both internal and external staff often proves to be the most effective. ShiftMed combines elements of various staffing solutions to create a customized approach that maximizes flexibility. For instance, a hospital might use ShiftMed to visualize their internal staffing float pool first before tapping into any external on demand or contract labor. This allows facilities to tailor their staffing strategies to specific budgetary requirements. 

LCMC Health and SSM Health Turn to On Demand Staffing

LCMC Health and SSM Health have successfully implemented on demand healthcare staffing models to address staffing challenges and improve operational efficiency. By partnering with ShiftMed, both health systems have been able to quickly fill staffing gaps with qualified local professionals, reducing reliance on costly travel nurses. According to Becker's Hospital Review, SSM Health saved millions in labor costs while maintaining high-quality patient care. This has proven effective in managing fluctuating patient volumes and ensuring consistent care. 

Implementing Staffing Flexibility Models 

Implementing staffing flexibility models requires a comprehensive assessment of current staffing practices and the specific needs of the healthcare facility. ShiftMed partners with facilities to analyze existing staffing workflows and identify areas where flexibility can address gaps or inefficiencies.  

Staffing flexibility models are essential tools for modern healthcare facilities aiming to maintain high-quality patient care while effectively managing costs and adapting to fluctuating demands. By understanding and implementing various staffing flexibility strategies and types of staffing flexibility, such as float pools, per diem staffing, contract staffing, and temporary staffing, hospitals can optimize workforce management. Embracing these staffing solutions will be crucial for the future success of healthcare organizations.