Rethinking Healthcare Staffing: The Case for Internal Resource Pools
Does your hospital or health system rely too much on overtime and agency staffing to cover shift vacancies? If so, it’s time to rethink your healthcare staffing strategy. Here’s why making a change is essential—and how it’s easier than you might expect.
A recent study published in JAMA Network Open found that nearly half of the hospitals analyzed exceeded safe thresholds for nurse overtime and agency staffing—putting patient care at risk. This research underscores the urgent need for hospitals and health systems to focus on sustainable, high-quality workforce solutions.
Researchers from George Washington University and Premier analyzed data from 70 U.S. hospitals between January 2019 and December 2022, examining how nurse overtime and agency staffing impacted quality measures, including rates of pressure ulcers.
Agency staffing hours exceeded safe thresholds by an average of 140%, while nurse overtime surpassed recommended levels by 63.6%. Also, agency hours had a statistically significant association with post-surgery hemorrhage or hematoma rates.
As a healthcare leader, you have the responsibility of protecting your workforce. However, with tight budgets and rising costs, investing in better staff scheduling can sometimes take a back seat. Without rethinking your current practices, you could miss out on opportunities to boost staff engagement and cut costs. Have you ever considered integrating internal resource pool (IRP) management into your operations?
What Is Internal Resource Pool Management?
In healthcare staffing, internal resource pool management is a centralized workforce solution that helps hospitals and health systems manage and allocate nursing and allied health resources across various departments and functions. IRP management empowers these organizations to own their healthcare workforce strategy by increasing internal staff engagement and decreasing overtime and agency reliance.
IRP Benefits Include:
Efficient Resource Allocation and Utilization
Improved Care Continuity and Patient Safety
Seamless Coordination Across Different Departments
Reduction in Unnecessary Labor Costs
Internal Resource Pool vs. Nurse Float Pool
An internal resource pool, also known as a nurse float pool, is a team of healthcare professionals employed by an organization who are ready to provide clinical support as needed. They fill gaps across departments or facilities to maintain consistent, high-quality patient care. For example, these nurses can cover scheduled PTO or during unexpected admission surges.
Building a Robust Internal Resource Pool
If your organization lacks an internal resource pool—or has one with low engagement—start by analyzing your workforce. Review historical staffing trends, utilization, and turnover rates, and assess your team’s flexibility needs to identify gaps and opportunities.
You may discover that offering greater job flexibility or personalized incentives can boost shift participation in your internal resource pool. For instance, if you rely on PRN nurses, consider shifting focus to float nurses. While both work on an as-needed basis, your PRN nurses might prefer flexibility over fixed schedules—making the float pool model more appealing, as it lets them choose when, where, and how often they work.
Offering total job flexibility helps attract more local talent to your internal pool—and encourages current employees to get involved. By cross-training staff across departments and offering professional development opportunities, you expand your coverage, strengthen retention, and increase employee satisfaction.
Next, having the right technology and scheduling infrastructure is essential to optimize and allocate your internal resource pool effectively. When selecting an IRP management solution, look for one that seamlessly integrates with your existing systems, automates scheduling to reduce administrative burden, and delivers real-time data and predictive analytics to drive workforce efficiency.
Real-World IRP Management Example
Low float pool participation caused UNC Health to struggle with staffing gaps, burnout, and potential care disruptions across 258 clinics. To address these issues, the North Carolina health system adopted ShiftMed Flex, a customizable app that gives float nurses 24/7 access to open shifts and full control over their schedules, improving coverage and staff satisfaction. In just three months, float nurses doubled their commitment from four to eight monthly shifts.
IRP Management Considerations
While many hospitals and health systems aren’t able to eliminate external staffing support, they can still use IRP management to maximize float pool engagement, reduce labor costs, and maintain patient care continuity.
ShiftMed Flex, for example, prioritizes your internal resource pool to fill scheduling gaps. But when patient volume spikes or unexpected admissions arise, you can instantly access local ShiftMed nurses through the app—ensuring seamless, on-demand clinical support. Furthermore, your core internal staff may not always have the expertise required for a shift. ShiftMed can help. We employ per diem healthcare professionals across 50 clinical specialties.
Our per diem healthcare professionals function as a true extension of your workforce. Fully credentialed and compliant with all professional standards, they’re W-2 employees of ShiftMed—meaning we handle their payroll and take full responsibility while they’re working in your facility. Our clinicians are local, so there’s no need for fixed-term commitments. On average, facilities save up to $300 per shift compared to the cost of travel nurses.
ShiftMed solutions integrate seamlessly with top enterprise software providers, including UKG, Workday, Symplr, PeopleSoft, and more.
Prioritize Your Nurses, Optimize Your Costs
How does ShiftMed Flex optimize shift fulfillment when your hospital or health system uses a mix of internal and external float nurses?
Our AI-powered Intelligent Routing Technology™ puts your internal staff first, filling open shifts cost-efficiently before turning to external resources. Factoring in overtime trends and minimum shift commitments, the technology routes each vacancy to the most qualified clinician at the lowest possible cost—giving you complete control, significant savings, and zero guesswork.
Your nurse scheduling team posts shift vacancies in your system as usual.
Intelligent Routing identifies the best internal staff options for these vacancies.
Vacancies are posted to ShiftMed Flex in real-time for the best internal nurses to claim.
Unclaimed shifts become available to the most suitable ShiftMed nurses to claim.
Any unclaimed shifts open up to agency labor as a last resort.
Conclusion: A Better Way to Staff Starts from Within
The future of healthcare staffing hinges on flexibility, efficiency, and sustainability—and it starts with optimizing the resources you already have. By prioritizing internal resource pool management and leveraging technology like ShiftMed Flex, your organization can boost workforce engagement, reduce dependency on costly external staffing, and improve patient care outcomes.
With the right strategy and tools in place, it’s entirely possible to meet fluctuating patient demands without overburdening your team or your budget. Whether you're strengthening an existing float pool or building one from the ground up, now is the time to rethink your staffing model and embrace a more innovative and proactive approach to workforce management.
Ready to empower your team and take control of your Workforce strategy? ShiftMed is here to help. Schedule a workforce consultation today!