How to Build an Effective Contingent Nurse Workforce

Travel nurses, per diem nurses, and contract staff can help cover gaps alongside a hospital’s permanent workforce. A contingent labor strategy should make the role of each staffing source clear: which needs it will cover, how clinicians will be supported, and how the organization will evaluate cost and performance.

The question is how best to leverage both permanent and temporary nurses to benefit patient safety, care quality, and hospital financial health overall? Innovative, thoughtful workforce strategies are required to optimize the way talent resources are balanced in hospitals and health systems moving forward.

In the past, hospital leaders have been hindered from developing and deploying a comprehensive labor strategy by a lack of meaningful data and supportive technology. Today, that reality is evolving, and hospital executives and healthcare staffing leaders have more tools at their fingertips. When implemented and applied correctly, these tools can help build a proactive, sustainable contingent nurse workforce plan that incorporates full-time employees as well as temporary labor support. In this post, we’ll explore why it is important to build a contingent labor strategy and share some best practices for integrating contingent labor effectively.

Plan for changing staffing needs

A workforce plan needs to account for both recurring demand and unexpected gaps. Review seasonal needs, vacancies, and nurse turnover alongside the capacity of your core team and internal flexible workforce. Use current organizational data to decide where external support fits, rather than relying on pandemic-era market forecasts.

Benefits of Building a Contingent Nurse Labor Strategy

Today’s nurse staffing market demands a combination of contingency (travel nurses and per diem) and permanency (in-house employees and internal float staff). Rather than trying to eliminate the contingent nursing costs altogether, the key to success is being strategic about when and how to utilize each staffing source. Benefits of including contingent labor in your overall staffing strategy include:

Support for seasonal surges

It’s important to have a dependable supplier of external nurses for certain predictable surges in visits and admissions. Flu season, for instance, typically hits urgent care facilities, EDs, and ICUs fairly hard during the winter months. Tourist areas and event hubs also experience an influx of patients at vacation-friendly times of the year. In situations like these, it is more costly and demanding (in terms of time and money) to hire and onboard extra FTEs than to rely on temporary nurse staffing support.

Opportunity for learning

Introducing external nurses into your existing unit staff can provide the opportunity for learning for both external nurses and existing staff. Clinicians who have experience at many different organizations will often have excellent insight and a fresh perspective on what is working well and what could be improved. When nurses can be a conduit of knowledge and best practices to their peers, the entire industry will benefit.

Expansion of internal workforce

If a travel nurse’s experience at your organization is positive, they may want to stay on as an employee (in full-time or float capacity). Be thoughtful about observing the performance and culture fit of external nurses to evaluate who might be a good addition to your team (if they are interested).

Assistance on specific projects

Contingent nurse labor can also be greatly beneficial when you are looking to accomplish short-term initiatives or projects. You may simply need some extra hands-on deck, or you may be looking for a temporary nurse with specific expertise crucial to the job at hand (e.g., an EMR transition nurse).

Best Practices to Build an Effective Contingent Workforce

It is important to lean on a handful of best practices to strategically incorporate contingent labor into your overall workforce management strategy.

Gain insight from current staff

Temporary nurse placements can be disruptive to unit culture and operational flow. Consult your current nurses to learn what traits and skills external nurses need to blend in well with your units and teams. Use this feedback to help you decide how to find contingent nurses. Evaluate and select a staffing partner that can match those needs.

Review your staffing mix

Set and review your staffing mix using your organization’s patient care needs, clinician availability, budget, and applicable staffing requirements. Track how each staffing source performs, and revisit the mix as those needs change.

Build an internal agency

Internal agency programs are composed of flexible clinicians (RNs, CNAs, etc.) or allied health professionals employed by the health system who work long-term contracts (4-26 weeks) or day-of staffing assignments spanning multiple specialties, facilities, and even states. Most programs offer full-time or part-time employment, vacation hours, insurance, and other benefits to internal agency nurses, while also offering the higher pay and flexibility typically only afforded by external agencies. With an internal travel program, nurses also can benefit from the new skills and experiences gained by working across multiple departments, hospitals, and even geographies. Meanwhile, your facility enjoys greater visibility into contingent resources and higher control of contingent labor spend.

For practical steps to evaluate suppliers, monitor performance, and manage the vendor relationship, see our healthcare VMS best-practices guide.

Take advantage of technological advancements

Technology now exists to help you more effectively manage and track contingent staff. New tools empower hospital leaders to move beyond outdated staffing strategies and take advantage of more integrated, flexible solutions. Technological advancements open a whole new world of internal contingent workforce management that was not previously available to healthcare leaders. Today, technology reduces common needs for external MSPs (like lack of data to accurately forecast hiring needs, minimal visibility into available workforce, and little bandwidth and processes to deal with hiring and managing contingent labor). Increasingly, technology distills valuable data, automates staffing processes, and gives you a more holistic view of available resources. This shift enables you to self-manage your contingent workforce without exhausting bandwidth and budget resources.

How to Overcome Contingent Labor Challenges

Health systems need a marketplace for contingent work that allows them to access the right clinician for a given need—but they may not have the structures and tools in place to enable them to do so. Many organizations are dealing with siloed data, limited reporting, manual processes, and incompatible technologies. In these conditions, it is next to impossible to predict and fill immediate demand, much less to forecast and prepare for long-term labor trends. In each case, thousands of possibilities must be evaluated and analyzed. The bare minimum requirements to accomplish this at scale are centralized data, automation capabilities, and advanced AI.  

This set of requirements might sound intimidating, but at their core, they simply repurpose models already leveraged by companies like Uber. By using data-driven technology to review all possible combinations and match each demand to the best choice in supply, hospitals and health systems can:

• Centralize all staff and shifts to one system  
• Categorize and stratify the modes of supply available for any given shift based on cost, availability, skills needed, and other variables  
• Enable more flexible frameworks for managing nurse staffing  
• Reduce administrative burden on schedule managers
• Improve satisfaction of temporary and permanent staff  
• Sustain a comprehensive, creative nurse staffing strategy  

Where to Find the Right Technology to Manage your Contingent Workforce

Look no further than Trusted Health Works. Works is a single platform that hospitals can use to optimize their labor costs and streamline the source-to-pay process. With powerful back-end technology and a user-friendly interface, Works:

• Adeptly predicts your shift gaps and offers solutions
• Intelligently combines your internal clinical teams with both long- and short-term contract labor to create a unified supply pool
• Programmatically recruits clinicians in your network to fill open shifts in the most cost-efficient way
• Handles source-to-pay, including tracking and validation of all compliance and onboarding documents to ensure compliance

Talk with Works about your internal and external staffing needs and how to evaluate a workforce management platform.