Save $37,000 a month by creating a float pool’

How would you like to have a pool of reliable nurses to fill your staffing holes — without incurring astronomical agency nursing costs? At Gwinnett Medical Center in Lawrenceville, GA, a "float pool" of ED nurses cut agency usage in half in only three months, reports Sandy Vecellio, RN, BSN, clinical manager for emergency services.

Nurses volunteer to participate in the float pool and are pooled from five EDs in the hospital system, she explains. The float pool nurses have a set schedule, but don’t know in advance which ED they’ll be working at on a given day, notes Vecellio.

"That morning or evening, we look to see where the need is and put that staff in the hole. They call in before they come to work to see where they need to go."

Currently, the float pool has seven ED nurses, but the number is growing quickly, says Vecellio.

An agency nurse costs more than twice as much as a regular staff nurse, with pay of $55 per hour compared with $25 per hour, says Vecellio.

Previously, 949 agency nurse hours were used in a typical month, which cost the ED an additional $23,725, as compared to regular staff nurse pay; whereas, the average now is 85 agency hours costing $2,125, for a savings of $21,600, she adds..

"We have also been able to decrease overtime and incentive pay for nurses who picked up extra shifts," Vecellio continues.

"We pay $10 extra an hour for one hole in the schedule and $20 for more than one hole," she says.

Before the float pool was created, incentive and overtime pay totaled $33,000 in one month, and this decreased to $17,000 three months after the pool was created.

"It has steadily been decreasing, and we hope building up the float pool will decrease it even further," adds Vecellio.

The float system already was in place for medical/ surgical and critical care, but it was determined that the ED needed its own float pool, she reports.

The ED nurses were informed about this at staff meetings, and they all had the opportunity to apply for these positions if they wanted to, she says.

As an incentive, nurses are given a 20% differential on the float pool hours they work, Vecellio explains.

"Nurse are first used to fill any vacant holes; and if there are none, then we look at canceling someone with incentive or overtime pay, or an agency nurse," says Vecellio. "Also, with a large ED, there is almost never a day with no call outs or holes, so the float pool helps to keep our staffing where it needs to be."

[Editor’s note: For more information, contact Sandy Vecellio, RN, BSN, Clinical Manager, Emergency Services, Gwinnett Medical Center, 1000 Medical Center Blvd., Lawrenceville, GA 30046. Telephone: (678) 442-3243. Fax: (678) 442-4531. E-mail:]