High labor costs continue to negatively impact operating margins and create financial challenges for hospitals. At the same time, leaders must ensure adequate staffing to meet rising demand, deliver high-quality care and combat clinician burnout.

While many hospitals rely on contingent labor and agency partners to fill gaps, another powerful lever is often underdeveloped: the Internal Resource Pool (IRP), sometimes referred to as a float pool. When strategically designed and supported with the right technology, IRPs offer organizations a flexible, scalable and financially prudent approach to workforce management.

Why Internal Resource Pools Matter

Most hospitals cover about 70% of patient volume with their full-time core staff, according to Kathy Kohnke, Senior Vice President of Client Services at Ingenovis Health. That leaves a sizable gap – often 30% or more – that must be filled through overtime, float pools or contingent labor.

The challenge? Overtime is costly and unsustainable. “According to best practices, only about 3.5% of labor pool usage should be overtime,” Kohnke said. “When hospitals reach 10%, nurses start to get burned out, and we see an increased risk of mistakes.”

Float pools help bridge this gap, offering a built-in bench of clinicians who can be deployed quickly across units, service lines or new initiatives.

Benefits of an Optimized Internal Resource Pool

1. Cost Efficiency & Transparency
   Overtime and turnover drive up expenses, often overshadowing the true cost of staffing. Kohnke notes that once benefits, onboarding and hidden expenses are included, contingent labor often aligns closely with the cost of a core employee. Internal pools help organizations strike the right balance, controlling premium spend while reducing burnout.

2. Agility in Demand Fluctuations
   From flu surges to new service lines, float pools provide immediate flexibility. “When a hospital implements a new EHR system, they need to pull nurses off the floor for training,” Kohnke explained. “Contingent or float pool labor helps fill those gaps seamlessly.”

3. Enhanced Quality & Cultural Fit
   IRP nurses already know the systems, workflows and culture. This reduces onboarding time and supports consistent patient care. In addition, coming out of the pandemic, many clinicians are interested in “gig” work and want more flexibility. Float pools allow you to keep those clinicians engaged and working for you, increasing retention and flexibility.

4. Credentialing & Compliance Oversight
   Technology-enabled credential management ensures float staff are only assigned where they are qualified, minimizing risk and simplifying compliance.

5. Revenue Protection
   Staffing shortages risk lost revenue if patients cannot be admitted. “You never want to turn away patients,” Kohnke said. “You need adequate staff to support throughput and high-quality care, so people want to return to your hospital.”

Building and Optimizing Your Pool: Best Practices

1. Assess and Strategize Whiteboard the end-to-end staffing process – recruitment, scheduling, credentialing – and identify pitfalls. This helps align internal resource pools with broader business and clinical goals.

2. Recruit and Retain Flex Talent Because float pool staff often transition into permanent roles within a year or two, hospitals must treat recruitment as an ongoing cycle. Proactive hiring and incentives like shift premiums help sustain pool strength.

3. Leverage Technology for Scheduling and Visibility A modern platform allows leaders to view open shifts across units, push assignments electronically, and integrate with time and attendance systems. This creates real-time visibility into overtime exposure and staffing coverage. “It’s like being an air traffic controller,” Kohnke said. “You need to see all units at once and make labor decisions in real time.”

4. Build Policies and Union Alignment Clear policies around eligibility, shift assignments and compensation ensure fairness and engagement. In union environments, float pool rules should be integrated into bargaining agreements to avoid conflict.

5. Monitor, Measure and Adjust Track utilization rates, fill times, overtime reduction and revenue impact. Use feedback loops from managers and clinicians to continuously refine the pool’s size and structure.

Partnering for Success

Even the most well-designed IRP may not fully eliminate the need for external partners. Many leading hospitals pair float pools with contingent labor providers to maintain flexibility and access to specialized skill sets. The result is peace of mind - knowing the right staffing is available at the right time and at the right cost.

As Kohnke summarized: “Float pool solutions provide the right staffing at the right time at the right cost. With those three legs of the stool, hospitals and health systems know they have a viable solution.”

IRPs are no longer a “nice to have,” they’re an essential part of a sustainable workforce strategy. By blending float pools with contingent partnerships and supported by technology, hospitals can reduce financial strain, protect staff well-being and ensure consistent, high-quality patient care.

Ingenovis Talent Operations (ITO) helps healthcare leaders design and optimize internal staffing pools, while integrating seamlessly with MSP, VMS and EOR models. Together, these strategies build the resilience today’s hospitals need for tomorrow’s challenges.

Want to dive deeper? Read the full white paper by Kathy Kohnke and Becker’s Healthcare for a detailed look at float pool strategy and best practices: Download the white paper here