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COVID-19 Surge Staffing Solutions Fact Sheet


Jill Williams

Jill Williams

Vice President of Workforce Development



Fact Sheets


  • COVID-19
  • Disease Management
  • Workforce


coronavirus COVID-19 fact sheet workforce

Issue Summary

A multilayered workforce plan enables hospitals to surge to inpatient capacity and/or stand up alternative care sites. The information provided in this document provides guidance and flexibility in designing the staffing plan hospitals deem most appropriate.


Issue Guidance

Reassign staff from low-volume areas to COVID-19 response teams.

Staff must have the appropriate skills for the new area. Apply appropriate cross-training. If reassigned to a different level complexity role or job, are salaries adjusted? Who is reassigned and in what order? If asking for volunteers, are you prepared if there aren’t any? Is there a preexisting policy about reassignment that needs to be followed or modified? (i.e. utilize staff from GI lab, pain clinic, surgery, PT/OT)

Implement new staffing models to enable greater use of available staff (i.e. team nursing or tiered staffing models).

Consider team nursing or having experienced R.N.s oversee R.N.s from other areas. Create R.N. positions for COVID-19 units to enable specialized nurses to have higher patient ratios. Staff must have appropriate skills for new areas when reassigning, which some have addressed by implementing the following.

  • just-in-time documentation class
  • rapid onboarding programs
  • refresher class on phlebotomy

Examples of Current Surge Staffing Strategies



Lessons Learned Speaker Series

The COVID-19 Lessons Learned from Missouri Hospitals is a speaker series that reflects on COVID-19 and its impact on Missouri hospitals, while looking forward to help prepare for what may yet come. A list of upcoming events and past recordings are available.


Deploy advanced practice providers in nontraditional roles as necessary.

  • APRN is hospitalist role
  • APRN or P.A. to staff triage area
  • CRNAs to work in ICU

Additional information:

Work with State licensing boards to identify licensed N.P.s or P.A.s.

Recruit local or regional medical office or ambulatory staff to fill necessary short-term/temporary roles.

These medical practices may be able to help on a short-term/temporary basis. Focus on freestanding surgery centers, physician practices and other areas that might be shut down due to COVID-19.

A short orientation would be needed, or choose roles that do not need expertise or direct-care knowledge.  Try to match skills. Nonclinical staff could act as screeners or transporters, or one-on-one sitters with little orientation

Recruit other health professionals temporarily displaced or not currently working to fill necessary short-term/temporary roles.

Temporary or full-time permanent needs could be addressed with staff that have been laid off or furloughed. Fast-track hiring and reconfigure the onboarding process.

Additional ideas:

  • Place LinkedIn, Facebook and Indeed ads.
  • Utilize a CRM system to identify candidates who might have applied previously.
  • Recruit through social media.
  • Host virtual recruitment events.
  • Utilize SHRM and Lean Human Capital resources.
  • Send a “call-to-action” letter to past employees.

Assign nursing school faculty or school nurses to appropriate roles in the COVID-19 response.

Reach out directly to nursing schools and other schools. Collaborate with local school districts and other colleges/universities on similar programs.

Assign graduate nursing or medical students who are prelicensure.

  • Hire GNs prior to them passing the NCLEX and onboard/orient pre-NCLEX. Ensure appropriate waivers or other criteria are met, allowing the GN to work in the GN role.
  • Medical and other health care students could be used in different roles within the hospital.

Recruit nursing students in their final year who can be hired as unlicensed assistive personnel.

Contact nursing schools directly. Use a text message campaign, Facebook campaign and all social media avenues.

Reinstate retired staff or providers to non-COVID-19 care teams or areas.

  • Do they have an active license? If not, are there waivers in place to bring them back into the workforce?
  • Expedite orientation.
  • Are they high-risk and/or have other medical issues?
  • Rapid reactivation of access to organizational technology and systems.

Recruit nurses from other states.

Host virtual interviewing events. Work with area Chamber of Commerce to determine less impacted areas or furloughed nurses. Verify the nurse has a license from a compact state using Nursys.

Use flexible staffing for hospital leaders.

Consider flexible shifts for leaders to meet their family needs and also be present for leadership support during hours of operation when they may not traditionally work. A nurse leader in “patient experience” could work nights or weekends to facilitate a strong leadership presence and be able to care for family who may be out of school and/or daycare.

Assess the need for alternate care sites.

Whether these sites offer screening services or low acuity predischarge care, staff from clinics and other areas where services are limited can reassign or opt to work in these care areas. Hospitals also may need to consider transfer of patients. If other hospitals’ staff are not available to come to you, you may have to go to them. There are certain waiver flexibilities that support these movements during a crisis under the CMS Hospital Without Walls initiative.

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