How to Choose the Right Healthcare Staffing Model

A well-run medical setting with satisfied patients and nurses is a big win for a facility looking to provide top-notch care. However, we must acknowledge the reality: The people behind the care matter as much as the care itself.

In other words, we need to start taking better care of our nurses and healthcare professionals. This begins with choosing the right healthcare staffing model to keep happy and non-burned-out nurses at the bedside of every patient in need.

So, what healthcare staffing models are working in hospitals and other healthcare facilities throughout the U.S., and which ones aren’t? While there is no right or wrong when it comes to staffing models, more evidence is popping up to suggest that flexible staffing methods are the way to go.

Read on to learn why.

What are healthcare staffing models?

Healthcare staffing models are frameworks for how healthcare facilities schedule their staff to make sure their patients get the care they need. Staffing models inform how many workers are needed, what types of staff are needed, and when they should be scheduled to work.

Whether it's a bustling hospital like Accordius Health with over 3,226 beds, or a quiet assisted living community, how a facility staffs its teams significantly impacts patient outcomes.

Healthcare staffing models have evolved over the years. Many models enhance labor optimization by switching from a centralized to a decentralized staffing system. Centralized vs. decentralized staffing systems impact response time and staff wellbeing.

For example, a decentralized staffing model permits faster response times when filling openings at a facility because staffing is handled locally, and decisions don’t have to go through a central office.

As a result, facilities will have a better chance of staffing nurses on demand more efficiently and with a faster turnaround time. This is just one example of how to build flexibility into your primary staffing model to reach staffing efficiency.

Healthcare staffing models vs. options: What’s the difference?

The difference between staffing models vs. staffing options is that a staffing model is the overarching framework that helps a facility achieve or surpass its workforce needs, while staffing options are the resources that your facility uses to reach those workforce needs.

A strong healthcare staffing model is structured so that teams are well-organized, a hospital or other facility is adequately staffed, and patients get the care they need and deserve.

On the other hand, staffing options are the resources that your facility will tap into to strengthen its staffing model. These options may include hiring permanent staff members who serve as the foundation of your facility's workforce and using per diem nurses to fill any gaps in coverage.

Common healthcare staffing models

The most common healthcare staffing models include fixed traditional staffing. Fixed staffing means a facility hires a core team of nurses, both full-time and part-time. This fixed staff workforce works at the facility with no predetermined end date.

These nurses receive compensation packages including employee benefits. These benefits may include paid time off, health insurance, sick leave, overtime, tuition reimbursement, and childcare.

The benefits of having a fixed traditional staffing model include continuity of care and enhanced nurse accountability. The disadvantages of this fixed staffing model are a lack of scheduling flexibility for nurses and higher costs associated with benefit packages and overtime.

Here are some other common healthcare staffing models.

Core and flex staffing

Core and flex staffing involves a core team of nurses and other healthcare professionals working for your facility, supplemented with contingent staff when needed.

For example, let’s say your facility has a core team of in-house nurses who generally like to take time off during big American holidays such as the 4th of July or Christmas.

As a nurse scheduler or manager, you would love to give your permanent staff a break during these holidays, but you also know that there will undoubtedly be higher influxes of patients and that patient acuity can fluctuate during these times. You will need to be prepared and appropriately staffed, and choosing a flexible or core-flex staffing model will help you do just that.

You can begin by scouting out a contingent workforce, such as PRN or travel nurses, to meet your facility's changing needs and patient demands. Using PRN nursing can be particularly beneficial for facilities. For example, Nursa, a flexible healthcare staffing platform, helps healthcare facilities, hospitals, and health systems find the clinicians they need, when they need them.

Among the benefits of having a core-flex staffing model is that you will have supplemental staff to fill in for gaps in coverage when patient headcounts are high. You will also be able to grant the time off that your core staff needs.

The disadvantage of a core-flex staffing model is that it may be more challenging to manage consistency in care as contingent nurses are not as familiar with a hospital’s or other facility’s protocols.

Float pool model

A float pool refers to staff who can apply their nursing expertise across multiple departments. It’s typically a team of internal PRN staff who work on a flexible basis and can be called upon (often last-minute) during times of high patient volumes. Healthcare talent pools may also include agency nurses or independent contractors.

The main benefit of float pool staffing is that PRN nurses can quickly show up and fill a shift if an in-house nurse calls out sick or if the patient census increases.

The disadvantage of float pools is that nurses may be less familiar with the unit’s or the facility’s protocols on patient care and may not always be available when asked to fill a shift at the last minute.

Acuity-based staffing model

Acuity-based staffing runs parallel to implementing a core-flex or float pool staffing model, but as a staffing manager, you will staff your facility based on patient acuity, not just headcount.

For example, emergency rooms show an increase in patient volume by 5–12 percent during the holiday season. Many of these increases are brought on by respiratory conditions and influenza, which are rated lower on the acuity scale when symptoms are mild to moderate.

However, holidays also increase the number of patients who come into emergency rooms requiring critical care for falls or slips, sharp object injuries, and poisonings. These afflictions are considered higher on the acuity scale and, therefore, require higher staffing levels to provide the appropriate hours per patient day.

An acuity-based staffing model will piggyback on a float pool model and core-flex staffing model to ensure there are enough specialized nurses on staff to handle the influx of patients with varying acuity levels.

How to select the right staffing model for your facility

Being deliberate about choosing the right staffing models is the main ingredient that leads to excellent patient care. Selecting the right staffing model for your facility is critical, but where do you begin? Is there the most effective staffing model in healthcare? Every facility is different, so let’s break down how to choose the right model for your staffing needs.

1. Assess the type of facility you are running

The facility type will influence what staffing model best fits your needs.

For example, a hospital will be faster-paced than a quiet assisted living facility. A hospital may, therefore, do better with an internal PRN float pool that can be called upon in times of high patient surges. A quiet assisted living facility, on the other hand, may benefit from core-flex staffing, in which a few per diem nurses are sourced when nurse employees call out.

2. Consider patient acuity levels in your facility

For example, if you manage scheduling in an emergency department with a high volume of patients requiring critical care, you may need to rely on a float pool of staff with experience in trauma care.

An assisted living facility, however, will tend to have more stable populations with lower acuity levels. Using a fixed team of in-house staff with occasional supplementation with per diem staff will be important to keep things running smoothly.

3. Think what’s best for your nurse team

A happy nurse team leads to happier patients and better patient outcomes overall. It’s really as simple as that.

One of the most common causes of job dissatisfaction among nurses is related to high levels of burnout. This often stems from a facility being understaffed and nurses feeling overworked.

Ultimately, you should choose a flexible staffing model that maintains consistent coverage and makes nurses feel appreciated for their work, allowing them to rest and restore when needed.

Explore more staffing best practices with Nursa

Hey, we get it. We are in this game together. We truly believe that nurses are the backbone of healthcare; however, sometimes these backs get sore—like really sore.

Nurses have one of the most rewarding yet tiring jobs in the world. Caring for people physically and emotionally day in and day out is both exhausting and fulfilling. Facilities can best support their nurses by researching and implementing staffing models that promote a positive work-life balance and empowerment within a workplace.

Looking for the right talent for your facility? Start by finding reliable and cost-effective staffing solutions on demand, more easily than ever, to support your permanent staff.

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Select the right healthcare staffing model for your facility

Key takeaways:

What are healthcare staffing models?

Healthcare staffing models vs. options: What’s the difference?