How Hospitals Improve Margins During Seasonal Surges Before Costs Escalate

By Sarah Knight, ShiftMed Content Manager/January 20, 2026/Labor Strategy, Workforce Technology

Hospital CNO and COO meeting with nurse leaders to review workforce strategies for improving margins during seasonal surges.

Winter surges test hospital margins every year. Seasonal increases in patient volume, coupled with workforce challenges, can quickly escalate labor costs and strain resources. For C-suite leaders, specifically CNOs and COOs, these surges pose operational headaches that test their workforce strategy, foresight, and resilience.

Some hospitals scramble to fill shifts at the last minute, relying on overtime or contract nurses. Others take a strategic approach by anticipating surges, using real-time analytics, and building workforce flexibility. These hospitals improve margins during seasonal surges while maintaining high-quality care, demonstrating how foresight and planning can turn predictable challenges into advantages.

Consider a mid-sized health system that once experienced a nearly 25% spike in labor costs during flu season. This year, the CNO and COO used predictive workforce analytics to forecast census by unit, cross-trained nurses to cover multiple areas, and developed schedules that could be adjusted in real-time. When patient volume peaked, the hospital had the right nurses in the right places, avoiding costly last-minute contracts, reducing overtime, and maintaining high care standards.

Workforce Flexibility Is the First Line of Defense

Labor is the largest and most volatile expense during seasonal surges. Hospital leaders who rely on reactive staffing often experience overtime spikes, premium labor creep, and nurse burnout. Those who plan ahead create workforce models designed to flex with demand.

By analyzing historical census trends and applying predictive workforce analytics, leaders can align coverage before volume peaks. A thoughtful mix of full-time nurses, per-diem clinicians, float pools, and limited contract support allows hospitals to meet patient needs without overcorrecting or overspending.

Leaders can add another layer of resilience by cross-training nurses across units. When patient volumes shift unexpectedly, schedulers can redeploy nurses quickly, maintaining safe patient-to-nurse ratios while avoiding unnecessary costs. For CNOs, workforce flexibility directly protects care quality and financial performance.

Per diem nurse preparing for her hospital shift, representing workforce flexibility during periods of increased patient demand.

Real-Time Analytics Turn Insight Into Action

Planning alone isn’t enough. During winter surges, conditions change quickly, and yesterday’s reports arrive too late. Hospitals that improve margins during seasonal surges rely on real-time analytics to maintain control as demand fluctuates.

Predictive analytics help leaders see what’s coming, not just what’s already happened. Forecasting census and acuity by unit allows workforce plans to be adjusted days or weeks in advance, reducing last-minute decisions that drive overtime and contract spend.

When surges are underway, real-time data enables decisive action. Leaders can redeploy nurses, adjust shift coverage, and reallocate resources as conditions evolve, keeping operations efficient and aligned with patient needs.

Operational dashboards play a critical role here. By monitoring metrics, such as census trends, patient acuity, and premium labor usage, leaders gain immediate visibility into pressure points. These insights surface risk early, allowing hospitals to respond proactively rather than absorb unnecessary cost.

Hospital nursing leaders reviewing real-time workforce analytics to support operational planning.

Proactive Planning Protects Financial Performance

Hospitals that perform well during the winter months treat surge planning as a strategic discipline. Months before peak season, leaders review historical patterns, identify high-risk periods, and develop workforce plans that incorporate flexibility. Schedules are adjusted early, contingency coverage is secured, and operational teams align around clear expectations.

As winter approaches, proactive hospitals shift into continuous planning mode. Daily and weekly reviews of census, acuity, and staffing allow leaders to make small adjustments before costs escalate. This steady, proactive approach reduces the need for overtime and emergency staffing decisions.

Scenario planning further strengthens readiness. By modeling high, moderate, and low surge scenarios, leaders can understand the operational and financial impact of different labor responses in advance. When volumes spike unexpectedly, decisions are guided by preparation, not urgency.

Hospital leaders reviewing workforce challenges that impact margins during seasonal surges.

Technology Enables Operational Resilience

Hospitals that improve margins during seasonal surges utilize workforce and analytics tools to connect demand, scheduling, and costs in real-time. Modern workforce platforms offer visibility into scheduling gaps and cost implications across units, enabling leaders to act before premium labor becomes the only option.

AI-driven scheduling tools take this a step further, using historical data and predictive insights to align labor with anticipated demand. Schedules become more responsive, labor spending becomes more predictable, and last-minute adjustments become less frequent.

The most effective organizations embed these insights into daily operations. Analytics are used in staffing huddles, operational reviews, and leadership check-ins, enabling continuous course correction and sustained control throughout peak season.

Hospital COO reviewing workforce analytics with clinical team members.

Executive Takeaways for CNOs and COOs

Seasonal surges will continue to test hospital operations. The hospitals that consistently improve margins during seasonal surges share three core practices:

Workforce flexibility that absorbs demand shifts without excessive premium labor.
Real-time visibility that surfaces risk early and enables faster decisions.
Proactive planning that aligns clinicians, operations, and financial goals.

Effective leaders focus on a small set of high-impact metrics: overtime and premium labor utilization, census and acuity trends, workforce mix, and variance between forecasted and actual labor spend. These indicators provide early warning signals, allowing intervention before margins are impacted.

Most importantly, top-performing hospitals foster alignment between nursing, operations, and finance. Decisions are collaborative, data-driven, and made in a timely manner. This culture of foresight and flexibility enables organizations to navigate winter surges and enhances their overall performance throughout the year.

Conclusion: Control the Surge, Protect the Margin

By combining flexible workforce strategies, real-time analytics, and proactive planning, hospitals can efficiently meet patient demand, maintain high-quality care, and consistently improve margins during seasonal surges.

For CNOs and COOs, success hinges on acting early, utilizing data wisely, and building operations that can adapt under pressure rather than breaking.

Ready to Turn Insight Into Action?

See how real-time workforce visibility enables hospital leaders to reduce premium labor and maintain control during seasonal surges. Schedule a free workforce consultation with ShiftMed today!