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Building Internal Workforce Capacity with an Augmented Per Diem Nursing Program
Meeting the demands of staffing continues to require creative strategies from nurse leaders. This presentation will provide information on the structure, process, and outcomes of an internal per diem program which led to successful patient and staffing outcomes while remaining fiscally responsible.
Significance:
Variable staffing needs can be challenging for nurse managers to meet on a 24/7 basis. Various quick fixes, such as frequent pulling of staff and use of outside agencies, can be very expensive and result in poor patient outcomes, low nurse satisfaction, and increased organizational costs.
Strategy and Implementation:
An internal float pool offers one solution to avoid concerns of poor patient outcomes, low nursing staff satisfaction, and increased organizational costs. This 531-bed, twice-designated, ANCC Magnet, academic medical center designed an augmented per diem program to meets its organizational staffing needs. Based on feedback from the nursing staff, internal candidates were selected to participate in a tiered, premium program in which they were utilized only upon organizational need. Input from nursing leadership was obtained to proactively design and communicate schedules that best met patient care needs. Processes were established to allow nurses to select their tier and cluster that best met their personal needs and professional skill set. Unit managers utilize information provided in advance to determine additional staffing needs. Ongoing systematic evaluation of the program provides for process improvements to meet the workforce demands while maintaining quality patient outcomes.
Evaluation:
Five years post implementation, the program continues to evolve while sustaining stellar outcomes in areas of patient care, financial results, nurse satisfaction, and staff retention. Despite 96% occupancy and building of 139-bed tower, use of any external staffing resources is not needed.
Implications for Practice:
Nursing leadership supports the continual growth of the program to meet organizational needs. The structure and processes of this program can easily be replicated to other organizations with yielding of similar, positive results.