What You Need to Know

Most health systems have the flexible staff to reduce agency spend; they just can’t see them clearly enough to use them. Per diem nurses and float pool clinicians go external because the agency is faster and easier than your internal process. Visibility closes that gap. When your own staff can find and claim open shifts as easily as any external platform, the hours stay inside and the markup disappears.

Most health systems already have what they need to reduce agency spend. They just can’t see it clearly enough to use it.

Float pool nurses, per-dem staff, and part-time employees with available hours make up a flexible workforce that already exists inside your system. Many of them want more shifts. But when your internal process is slower and harder than an agency app, they go where it’s easier. They pick up shifts at other facilities through external platforms.

When your unit comes up short, you call an agency to fill the gap. You pay a 20–40% markup for staff who were ready to work but couldn’t find a frictionless way to do it inside your system.

This isn’t a staffing shortage problem. It’s a visibility problem. The fix doesn’t require a new program or a managed service. It requires making your internal capacity visible before the external call gets made.

Close the visibility gap. The capacity is there. Your process just isn’t surfacing it in time.

Why Your Flexible Staff Keep Going External

Per diem and part-time nurses don’t choose external agencies over your hospital because the agency pays more. In most cases they don’t. They choose the agency because the process is easier.

An agency app takes three minutes to sign up and shows available shifts in real time. Your internal process takes a call to a manager, a manual spreadsheet check, and a wait to confirm. By the time your manager has worked through the list, the nurse has already accepted a shift somewhere else.

This plays out across thousands of shifts a year. The result: your flexible workforce drifts toward external platforms. Your internal fill rate drops. Your agency spend goes up. The cycle reinforces itself.

The agency isn’t winning on talent. It’s winning on friction. Every manual step in your internal process is a leak in your labor cost control.

The Real Problem Isn’t Your Float Pool Tool. It’s Disconnection.

Many health systems already have technology for pieces of this — a float pool platform, a scheduling system, a VMS for contingent labor, and a separate process for per diem staff. The instinct when fill rates drop is to optimize each tool in isolation.

But that’s not where the leak is. The leak is in the gaps between those tools.

When a shift opens, the answer lives across several different systems. Permanent staff availability. Float pool coverage. Per diem candidates in the ATS. Contingent positions in the VMS that could be redirected internally. Each lever is real, but each one is visible only through a different tool, managed by a different team. A manager filling a shift in the next two hours can’t navigate all of that in time. So she defaults to the one option she can access quickly. And the window for an internal fill closes.

The result: managers default to the external call. Not because internal capacity doesn’t exist. Because finding it across disconnected systems takes more effort than calling the agency.

Having separate tools is not the same as having workforce visibility. Visibility means seeing all your labor — permanent, float, per diem, and contingent — in one place, in real time, before you make a staffing decision.

What Internal-First Staffing Actually Requires

Internal-first is a sound strategy. Most health systems already have a policy: use internal options before going external. The problem is simple. The policy exists. The visibility to support it doesn’t.

Three things have to work together to make it real.

  • Real-time visibility. Open shifts need to surface automatically so flexible staff can see and claim them without a phone call. Healthcare workforce visibility at the shift level is the foundation. If your per diem nurse can’t see your open shifts as fast as the agency app, she’ll go external.
  • Automated outreach. When a shift opens, available internal staff should be notified automatically before the request routes externally. The internal process needs to be as fast as the agency call, not slower. That speed is what makes internal-first operationally real.
  • Live performance data. Which units are consistently leaking shifts to external vendors? Which flexible staff are underutilized? What’s the cost difference between internally filled shifts and agency fills? Without that workforce intelligence, you can’t manage the gap or make the case to close it. Data turns internal-first from a goal into a managed strategy.

What Definity Does

Definity gives health systems the visibility to make internal-first staffing work in practice. It’s a workforce visibility and intelligence platform that connects every layer of your labor — permanent staff, float pool, per diem, and contingent — into a single real-time view.

When a shift opens, available staff across all internal labor categories are identified and notified in sequence. Every fill is tracked and costed in real time. You see where your internal capacity is being used, where it’s leaking external, and what each decision costs against budget. That’s labor cost control built on complete workforce visibility.

The result is genuine healthcare workforce optimization.

Your flexible workforce already exists. The question is simple: is your process easy enough that they choose you first?

Definity gives health systems the visibility, intelligence, and labor control to make internal-first staffing a reality.