The daily staffing routine in any hospital or healthcare facility is often stressful, and other factors, such as workforce shortages and nurse burnout, influence the ability to maintain staffing levels in the short or long term.
For many healthcare administrators, the day begins with the need to cover call outs, manage surging patient volumes, and solve nurse burnout.
This is not what managers want to be dealing with every day, is it?
To move forward, healthcare facilities must transition from short-term survival to sustainable healthcare staffing models.
Building this model of workforce requires more than just filling open shifts on a schedule. It requires a differentiated view of how we perceive healthcare staffing. This includes moving away from high-cost, bureaucratic, obsolete approaches such as traditional agencies and finally prioritising both the well-being of staff nurses and the financial health of the facility with a flexible staffing approach.
The State of Healthcare Workforce Sustainability
When facing high patient demand, staffing coordinators may feel the pressure from managers and administrators to meet labor demand without increasing costs too much. While a full-time hire avoids backlash from relying on staffing agencies or registry nurses, this often results in a bull-whip effect when patient census inevitably falls back to regular levels.
The correct way forward is to adopt a longer-term strategy that can respond to regular fluctuations in patient demand, without leading to overcorrections that can lead to unnecessary costs.
Short-Term vs. Long-Term Strategies
To understand the path to staffing sustainability, it is essential to compare short-term and long-term strategies.
Typically, many hospitals opt for short-term methods such as travel nursing and staffing agencies to fill gaps. Although these approaches work for specialised needs, they are high-cost solutions that can create friction between permanent staff and temporary contractors.
Long-term strategies focus on flexibility and cost control without treating every open shift as a crisis. Instead of defaulting to overtime or agency placements, sourcing nursing talent on a per diem basis helps facilities selectively fill shifts as needs arise without overspending.
A per diem shift marketplace platform like Nursa offers qualified clinicians on a per diem basis to help units tap into a broad pool of credentialed clinicians at a moment’s notice for specific shifts. Per diem shift marketplaces give healthcare facilities direct access to clinicians and help cut out agency intermediaries. This approach helps facilities meet demand with the precision of a scalpel without putting added strain on the staff nursing team.
As a result, staffing platforms like ShiftMed, IntelyCare, or Nursa help reduce overtime utilisation, reduce agency spend, and prevent burnout. Over time, this flexible staffing approach supports more accurate forecasting, better alignment with fluctuating census, and a more sustainable workforce strategy overall.
Best Practices for a Longer-Term Staffing Mentality
When considering long-term staffing, many facility managers might think that the easiest approach is to post open positions and hire the first nurse who applies. Actually, that is a path full of risks that should be avoided.
Adopt a Retention-First Approach
The foundation of any sustainable healthcare staffing model is the retention of the existing nurse workforce. It is significantly more cost-effective to retain an experienced nurse that you already know than to recruit and onboard a new one.
Smart facility managers invest in providing nurses with career pathing and professional development to show clinicians a clear future without needing to look for another place to work.
By reducing turnover through better support systems and strengthening the skills of core nursing staff, facilities can invest in efficiency. When nurses feel they have the tools and the support to grow, they feel committed to stay in the organisation.
Use Data to Guide Decision-Making
Sustainable staffing depends on more than filling open shifts—it requires consistent visibility into the data that signals when strain is building. Facility leaders should routinely review:
- Historical scheduling patterns
- Census trends and fluctuations
- Utilisation and coverage data
Together, these data points help anticipate staffing needs before they escalate into disruptions.
Early warning signs often appear well before a shortage becomes urgent. Rising call outs, increasing overtime hours, and repeated shift extensions can all indicate mounting staffing stress and burnout risk. Reviewing these indicators alongside historical census patterns allows teams to plan for predictable seasonal changes instead of reacting to last-minute gaps.
When facilities act on these insights early, they can intervene in targeted ways, such as:
- Adjusting schedules before overtime becomes routine
- Adding per diem coverage to relieve pressure points
- Reallocating resources ahead of expected census spikes
Over time, this proactive, data-informed approach supports more stable staffing and stronger workforce control.
Build Resilience for Unplanned Disruptions
Even the best-laid plans can encounter disruptions. The goal of long-term healthcare workforce planning is not to eliminate these disruptions but to build the flexibility and resilience to handle them gracefully.
While traditional agencies are often overkill for a single call out, per diem shift marketplaces provide a middle ground. They can function as a precise contingent staffing solution that allows facilities to cover call outs and sudden fluctuations in census without relying on excessive overtime utilisation.
This is a layered approach to staffing:
- The core full-time staff is the foundation of the unit.
- Internal flex or float layers to manage moderate variability in patient volume.
- Per diem platforms for short-term gaps and unexpected vacancies.
- Agencies reserved strictly for exceptional circumstances or long-term leaves.
Updating Measurement to Shift towards Sustainability
To ensure that these strategies will work, organisations must change how they measure success. Traditional metrics often focus only on budget gains, but a sustainable model goes beyond. It requires a clear set of key performance indicators (KPIs) that reflect the health of the entire facility, not just short-term cost control.
- Tracking overtime hours and turnover rates as core indicators of workforce strain and staff well-being
- Monitoring time to fill shifts or roles to identify persistent coverage gaps
- Measuring external labor spend to understand reliance on short-term staffing solutions and intermediaries
- Incorporating workforce feedback to ensure staff feel supported, safe, and heard
Ultimately, these staffing decisions must support both clinical and financial health. The stability of the workforce is directly linked to the quality of care provided. Unresolved problems can quickly affect the continuity of care and the patient’s safety.
Sustainability over Reactivity
The most resilient healthcare organisations are those that move away from reactive staffing decisions and toward intentionally designed flexibility. Moving toward sustainable healthcare staffing means recognising that the old ways of managing the workforce are no longer sufficient for modern healthcare systems.
Sustainable staffing is not about doing more with less; it’s about making smarter staffing decisions that support clinicians, control costs, and protect care quality for the long term.
By prioritising retention, leveraging data, and utilising flexible staffing models as a strategic tool for short-term solutions and long-term hirings, healthcare facilities can finally meet sustainability and ensure safe standards are respected.
