Beyond a Band-Aid Approach: An Internal Agency Solution to Nurse Staffing

The Institute of Medicine (IOM) affirmed that the employment of temporary or per diem nurses augments risk to patient safety. The IOM recommends health care facilities avoid hiring nurses working from a temporary external agency. The IOM recognizes the need for health care facilities to have a plan in place for situations when confronted with short staffing, higher acuity, and increased patient census. Based on recommendations from the IOM, an internal agency was developed in a university-based health care system. Cost savings were realized because of the collaborative efforts of human resources to fill vacancies, unit management managing their respective budgets by flexing staff based on patient census, and the development and implementation of the Enterprise Staffing Pool.