The Temp Staffing Solution That's Right Under Your Nose

Frustrated with the variable quality and supply of temporary workers, a California health system finds a reliable solution for temporary staffing challenges.

There are two main strategies for dealing with temporary staffing needs in healthcare. The first is to work with agencies to fill temporary gaps in staffing and find new talent; the second, which is less common, is to create your own pool of temporary employees to draw upon.

"People who are not part of your organization and who work for a vendor just don't have same commitment to the workplace," says Vic Buzachero, corporate senior vice president for innovation, human resources and performance management at Scripps Health in San Diego. "When you create your own pool of temps, the temps become a part of that organization's culture and share in everything."

While Scripps was once a major customer of several healthcare staffing groups, it decided to experiment with creating its own temp pool in 2009. Starting with 25 nurses, the temporary worker program, called Scripps System Resource Services (SSRS), has expanded to include more 700 such as pharmacists, nursing assistants, respiratory therapists, operating room staff, IT professionals, project managers, registered dieticians, cooks, food service workers, and administrative positions.

"It is an excellent feeder mechanism for us, along with our normal recruitment process," says Buzachero, who spoke with me about how his organization's created its own pool of temporary workers. This transcript has been edited for brevity and clarity.

HLM: How many of your temps will likely be hired to work for Scripps Health permanently?

Buzachero: There are about 700 people in our SSRS pool. About one-third of these staff will convert to regular employees somewhere within our organization each year. Growing the pool is really a challenge. Not only do we have to backfill the third who become permanent employees, but we have to bring in larger numbers. We are currently seeking to double the size of the pool. It has grown by about 100 people in the last year.

HLM: What are some potential pitfalls of using externally sourced temporary workers?

Buzachero: Any time you bring in people from outside organization on a temporary basis, they're not as familiar with systems and practices of the organization they're working with. All health systems and hospitals are a little different, and every role is a little different. Systems that are used, whether they be pharmacy control, charting, and so on, are all dependent on types of information systems you have.

If new, or certainly for a temporary worker, you might not be as familiar with everything that takes place within an organization. Not knowing the ropes is a real challenge. When we do have patient incidents, more than 50% of them can be attributed to an outside person. That number motivated us to create our own pool, so we have people who are familiar with our systems and processes.

HLM: What are some issues with temporary workers that are unique to healthcare?

Buzachero: The first is the bonding with a team. Healthcare teams work so intensely providing patient care that those teams bond very tightly. A temporary worker coming in is just like a new kid in school; you don't know anybody and you don't get a lot of help. Everyone's a highly trained professional, and it's assumed that, as a highly trained professional, you know what to do. That's a tough culture to walk into.

Second, there are certain legal requirements that we must go through in employing them. In other industries, you can hire anyone to do anything, but in nursing, for example, your nursing license only permits you to do certain things. Especially if you go from state to state, as each state has different regulations.

Interstate Medical Licensure Effort Gaining Ground

Which is another advantage of having our own pool. We're not pulling people from other states, and are not trying to learn what nursing means in California as opposed to Texas or Washington. The clinicians in our pool are all licensed locally.

HLM: What kinds of experiences has your organization had working with temporary staffing agencies?

Buzachero: We used to work with many different staffing agencies. Once the pool was started and in full swing, we were able to avoid working with them again until this year. We're currently using a few staffing agencies. No one staffing agency can meet all your needs, and, as a result of that, you may end up dealing with a large number of different staffing agencies.

If you asked even the biggest healthcare staffing agency in the country to send you 100 registered nurses, they wouldn't have 100 to send you. They might have 10, or 15. In another month, they might have another 10 or 15, but they couldn't fulfill your needs. Another challenge is that each agency has a different definition of quality and caliber of people, so you get great variability in the [quality of] people.

We do still have a relationship with some staffing agencies, but we're no longer a big volume client. We've hired on 38 people from agencies this year. Before we created our temporary worker pool, we sometimes had many as 500 people from agencies annually. You can imagine the nightmare of trying to manage all of those people from different agencies.

HLM: What further advice do you have for HR leaders considering bringing in temps, either supplied by an agency or from their own pool of workers?

Buzachero: Your patients are trusting you at their most vulnerable moments; the last thing you want to do is leave them with someone you don't know very well. They're trusting you with their lives. I think that's one of the key things about healthcare, and a perk of using your own pool to staff your temporary needs.