Understanding the Different Types of Healthcare Staffing Models

Your dedicated healthcare team is already stretched thin, yet another shift needs coverage. With patients still depending on quality care, you’re left asking the same exhausted staff to work overtime while trying to find additional support with little time to spare. This is where healthcare staffing models matter.

Understanding the different types of healthcare staffing, from permanent employment and per-diem work to float pools and digital booking, can help you plan beyond the next empty shift.

Designing a Sustainable Healthcare Staffing System

Healthcare facilities need staffing models to plan how many people they need, which skills they need, and when. Without that plan, some teams end up overloaded while others have time to spare. Because of this, patient care can suffer, and repeated overtime drives up costs. But hiring more people is only one part of the solution.

Managers also need to divide tasks clearly, check whether teams can finish their work, and understand why people leave. Manageable workloads and flexible schedules can help facilities retain their teams. That is why a healthcare staffing system needs to be flexible enough because patient numbers change, care becomes more demanding, and people take leave.

Most facilities combine long-term roles for daily work with extra help during busy periods, and recruitment partners can find suitable candidates when managers lack the time to recruit. To see whether the plan is working, track overtime, delayed tasks, turnover, and patient outcomes.

The Three Main Healthcare Staffing Models

Healthcare facilities have long relied on three main staffing models: permanent and long-term, per-diem, and temporary. They are the solid grounds for health staffing models because they meet the three basic needs in a facility: daily work, occasional shifts, and a quick help for a set period and many facilities actually use all three together.

1. Permanent and Long-Term Healthcare Staffing Model

This model creates long-term or permanent positions for a facility’s everyday services. Hiring managers decide the hours, duties, and pay, then plan for the cost over time. It is still the most common working arrangement especially in the nursing department.   In the 2022 National Nursing Workforce Survey, 70.2% of employed registered nurses worked full-time – this brought many advantages to the healthcare facilities who used this model.

Advantages

• Workforce stability: Regular positions make schedules easier to plan and reduce repeated bookings for everyday work.
• Training costs: Keeping roles filled means spending less on repeated hiring and training for new starters.
• Patient care: A steady team knows the routines and how to share information. This helps to keep the quality of patient care of the business.

Disadvantages

• Ongoing costs: Pay and benefits continue during quieter periods.
• Recruitment time: Hiring for a permanent or long-term role takes time. The facility may need to pay for overtime or temporary help until it fills the vacancy.
• Flexibility: Adding permanent positions for a brief busy period can leave the facility paying for hours it no longer needs.

When to consider this model Choose this model for work that needs doing every day or for a long time. Keep in mind the wages, benefits, and training costs, including preparation for new starters when comparing the costs of hiring someone on a part time basis.

2. Per-Diem Staffing

Per-diem staffing provides help for separate shifts when needed, without a regular weekly schedule. Managers choose the shifts they need to fill and book them directly or through an agency.  Did you know? Back in 2023 a national survey found that 7.8% of employed registered nurses worked per diem, which was about 343,000 nurses in the country that time.

Advantages

• Cost control: When you only hire someone for the shift needed it helps control spending rather than adding another employee for a permanent position.
• Flexibility: Managers can arrange help for absences or busy days without paying for a longer assignment.
• Workload: Filling an open shift can reduce the need for overtime and ease pressure on the regular team.

Disadvantages

• Availability: A shift may stay unfilled if nobody accepts it.
• Hourly costs: Higher hourly rates or agency fees can cancel out the savings if the facility books help often.
• Orientation: Managers need time to explain local routines to each new arrival. Sharing patient information between shifts can also take more work.

When to consider this model Use per-diem staffing for occasional absences, one-off gaps, or workloads that change each day. If the same shift needs filling every week, a permanent position may make schedules and costs easier to plan.

3. Temporary Healthcare Staffing

Temporary staffing provides help for an agreed time or job. The facility sets the duties, hours, costs, and end date. Temporary employees can either be hired directly or through an agency. Travel nursing is one example. In fact, in 2022, 6.2% of registered nurses worked as travel nurses.

Locum tenens is the physician version of this, where one doctor temporarily fills in for another during leave or while the facility looks for someone to fill the role. This happens more often than many people expect.

Advantages

• Workforce capacity: One agreed assignment fills a longer gap, so managers do not need to arrange every shift separately.
• Recruitment time: Temporary help can keep services running while managers recruit for a permanent role.
• Commitment: The contract lasts for the time needed, so the facility does not create a long-term role for short-term work.

Disadvantages

• Cost: Contract rates, agency fees, and travel or accommodation payments add up.
• Onboarding: Explaining local systems and routines takes time, leaving fewer hours for the work on short assignments.
• Handover: Managers must plan who takes over when the assignment ends.

When to consider this model Use temporary staffing for longer leave, seasonal busy periods, or vacancies that may take months to fill. Locum tenens is one perfect example, especially for a physician’s role. Agreement on the cost, dates, and who takes over afterwards before the contract starts is important.

Did you know? Temporary nurses help hospitals manage staffing shortages, but excessive reliance on them may increase patient falls and nurse injuries. A study of 286 nursing units suggests keeping temporary staffing below 15% of total nursing hours as a potential benchmark for safer staffing.

The Growing Limits of Traditional Staffing Models

As healthcare facilities faced the limitations of traditional staffing models, the need for more flexible solutions grew. Regular schedules struggled to keep up with changing patient demand, per-diem staffing depended on staff availability, and temporary contracts often came with higher costs.  These challenges paved the way for new staffing models designed to help healthcare facilities adapt more efficiently.

4. Float Pool Staffing

Float pool staffing shares one team across selected departments or sites. Managers send help from the pool when a department gets busier, instead of booking outside help for each gap. Each assignment must match the clinical skills the department needs.

Advantages

• Workforce capacity: A shared team helps busy areas without creating a new permanent position for every short busy period.
• Cost control: An internal pool can reduce external agency bookings and their fees.
• Team integration: The pool already knows the facility’s systems and routines, so it needs less preparation than outside help.

Disadvantages

• Training costs: Preparing staff for several departments takes time and money.
• Availability: When several departments need help at once, the pool can’t meet every request.
• Patient care: Moving staff without matching skills creates safety risks, which limits where managers can assign them.

When to consider this model Use a float pool when workloads rise and fall across departments or nearby sites with shared systems and similar clinical needs. Compare wages, training, and scheduling costs with the cost of the outside bookings it would replace.

5. On-Demand Digital Staffing

On-demand digital staffing uses a platform to advertise open shifts and arrange bookings. Managers post the shift details, and the platform connects them with people qualified to do the work. These systems can handle many bookings all at once – which is faster compared to humans.

Advantages

• Booking time: Posting a shift cuts down on repeated phone calls.
• Scheduling: A shared view of open shifts helps managers spot gaps and follow up sooner.
• Flexibility: Separate bookings let managers add hours when work gets busier.

Disadvantages

• Availability: An app cannot create more local help. A shift may stay open if nobody suitable is available.
• Cost: Platform charges and booking rates can make frequent use expensive.
• Preparation: Checking qualifications, setting up system access, and explaining local routines still take time before a shift starts.

When to consider this model Use digital staffing when finding available help and confirming shifts takes too long. First, check the fees, local availability, and preparation needed for new arrivals. If shifts still stay empty, review pay and working conditions as well as booking speed.

6. Internal Travel Programs

Internal travel programs arrange temporary work within a healthcare facility, often at different sites. This model handles hiring, contracts, and assignments itself rather than relying entirely on an outside travel agency.

Advantages

• Workforce capacity: Longer assignments cover gaps that occasional bookings can’t.
• Recruitment control: The healthcare facility is still the one who decides the skills needed and the terms of each assignment.
• Flexibility: The program can send staff to whichever participating site has the greatest need.

Disadvantages

• Cost: Hiring, travel payments, and paperwork can reduce the savings from using agencies less.
• Orientation: Each site must still explain its own routines, even if its within the same healthcare facility/company
• Administration: Managing contracts and placements internally adds work for recruitment and scheduling teams.

When to consider this model Consider an internal travel program when a larger healthcare facility often has longer staffing gaps at different sites. It needs enough work and support to run the program. Compare the full cost with outside travel contracts before deciding.

Conclusion

Choosing healthcare staffing models starts with understanding where the team needs help. Matching the model to your workload, budget, and daily needs shows how the right staffing model can go further and bring more benefits to the healthcare facility, including lower overtime costs, better staff retention, and more consistent patient care.