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Bottom-Line Boost: How Interims Are Rethinking Agency Hiring Practices

September 25, 2023


Bottom-Line Boost: How Interims Are Rethinking Agency Hiring Practices

In response to COVID, hospital margins drastically plummeted due to lower volume during surges. While the descent has begun to stabilize, the cost of business in the OR continues to rise. Nurses have retired earlier than expected, the cost of labor and supplies is growing, and retaining staff remains challenging.  

The use of travelers also exploded during the pandemic, but that decision came at a high cost. One of the many methods that facilities have utilized to shore up permanent staff—and keep them—is using Interims to build a solid foundation to save costs and boost revenue. Check out how Whitman Partners’ interim leaders have utilized travelers for this purpose, plus other tips to cut costs.  

Dante Wheat, BSN, MHA, RN

There has to be a paradigm shift where my job as an interim is to eliminate agency staff and backfill with permanent staff, even though I am an agency leader. It isn’t to maintain what you have until you find someone; the expectation is to increase surgical volume, reduce cost, increase quality, and meet or exceed fiscal demands. So, hospitals don’t mind spending that large dollar amount for this leader because they know that on the back end, they will improve program margins.  

In a previous assignment, we reduced travelers and were able to increase volume by 5%. We went from doing an average of 22 cases per day to 30. We revised contracts and helped spend less money there. We incentivized or met market cost thresholds when needed based on market personnel constraints. We understood that not everyone has the same skill set and that some skill sets are hard to obtain or retain.  

Paul Giles RN, CNOR, RNFA 

The first stage is getting the volume up and using travelers, but I create an exit strategy for them. I develop relationships with local educational institutions and get their scrub tech students to come in for a few assignments while they’re finishing school. When they graduate, I glean one or two of them that I think are a good fit for the hospital. With nurses, I sign them up for the Perioperative 101 course. They’ll spend half the day in class and half in the OR. I’ll start with ten and end with five or six that fall in love with surgery. I cater to them, and that’s how you grow the next generation of OR staff. I look for the ones with leadership potential as well. So, you’re constantly balancing the need for travelers to increase volume and the requirement to grow and retain a permanent team.  

Daryl Miller, BSN, RN 

Use expensive staff more effectively. RNs don’t need to clean rooms between cases, get supplies, and pick case cards. You could have a scrub tech, or an educated instrument room tech do those things. 

Look at contracts every two years— everything from instrument repair to housekeeping—because most renew automatically. Pay attention to the fine details, not just the cost. 

Jeff O’Brien, CRCST, BS 

You must retain the people you hire with a good culture and competitive pay. Do a market adjustment survey every few years to keep up with what is happening in the economy. It costs about $52,000 annually to train a new person coming on board at entry level, and you lose some efficiency because they’re still learning the ropes. When you have high turnover, training costs go up. We lose employees who might go somewhere else for $4 more an hour, and it might take only $2 to keep them.  

 If your facility has a need for interim leadership, contact Zach Parker or Ines Radic 

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