Healthcare staffing has always been complex. Patient volumes shift without warning. Nurses call out sick. A new service line opens and suddenly a unit is short-handed. For decades, hospitals and health systems responded to these gaps the same way: they called a staffing agency.
That approach worked, at least for a while. But rising agency costs, workforce shortages, and growing pressure on hospital budgets have forced leaders to look for smarter alternatives. One solution that has gained significant momentum is the internal resource pool, or IRP.
This post breaks down what an IRP is, how it works, and why more hospitals are treating it as a core part of their workforce strategy.
What is an internal resource pool?
An internal resource pool, sometimes called a float pool, is a group of healthcare professionals who are directly employed by a hospital or health system and available to fill open shifts across units and departments as needed.
IRP staff can include registered nurses, licensed vocational nurses, certified nursing assistants, radiology technologists, respiratory therapists, and other allied health professionals. They are already credentialed, already familiar with the organization's systems and culture, and ready to step in when and where they are needed.
Think of an IRP as an organization's own on-demand workforce, one that sits between the core permanent staff and external agency or travel labor. When a unit is short for a shift, managers draw from the IRP first before escalating to outside sources.
How is an IRP different from traditional staffing methods?
Most hospitals have historically relied on a few different models to manage staffing gaps:
- Overtime for existing staff, which can lead to burnout and quality concerns
- Travel or contract nurses from external agencies, which come at a significant cost premium
- Per diem workers sourced directly by the facility or through vendors
An IRP formalizes and centralizes a flexible workforce that belongs to the organization. Rather than reacting to staffing gaps by immediately reaching out to an agency, the hospital has a built-in layer of flexible capacity to draw from first.
The difference matters because agency and travel nurse costs have risen substantially in recent years. According to data cited by the American Hospital Association, contract travel nurses can account for a significant share of a hospital's total nurse labor expenses, often at rates that are two to four times higher than permanent staff. New York hospitals alone spent an estimated $1.7 billion on travel nurses in 2024, roughly four times what they spent before the pandemic.
An IRP helps hospitals regain control over that spending by using their own workforce first.
The key benefits of an internal resource pool
Lower labor costs
The most immediate benefit of a well-run IRP is cost reduction. When a hospital fills an open shift with an internal pool nurse instead of a travel nurse, they avoid agency markup fees, housing stipends, travel allowances, and the other expenses that make contract labor so expensive.
Organizations that invest in building a true IRP report meaningful reductions in external labor spend. Because IRP workers are W-2 employees or known per diem staff, organizations have far more visibility and control over what they are actually paying.
Better quality and continuity of care
IRP staff already know the hospital. They understand the electronic health record system, the policies, the workflows, and the culture of the units they cover. That familiarity matters a great deal in healthcare, where onboarding a new clinician quickly can carry real clinical risk.
When a travel nurse arrives from an agency, there is an adjustment period. When an IRP nurse steps in, there is not. This can translate to fewer errors, smoother handoffs, and more consistent patient experiences.
Flexibility to meet demand shifts
Patient volumes are not predictable. A flu surge, a mass casualty event, a new service line launch, or a wave of scheduled surgeries can all push staffing needs well beyond what a fixed workforce can handle. An IRP gives hospitals a ready layer of flexible capacity that can scale up or down based on actual demand.
This is particularly valuable for large health systems that operate multiple facilities. A well-structured IRP can allow staff to float between locations, expanding coverage across the system without increasing headcount.
Improved staff retention
One reason nurses leave for travel roles is flexibility. They want more control over when and where they work. An IRP can offer that same flexibility within the organization, giving clinicians the ability to pick up shifts on their own terms without leaving their employer.
This is especially relevant today. Many nurses who were drawn to travel nursing during the pandemic are now looking for more stability but still want schedule flexibility. An IRP can serve as a bridge, keeping experienced clinicians engaged with the organization rather than losing them to outside agencies.
Faster response to staffing gaps
When a shift opens up unexpectedly, time matters. Coordinating with an external agency takes time: sourcing candidates, verifying credentials, negotiating rates, and completing onboarding paperwork. With an IRP, qualified, credentialed staff are already in the system and can be notified about open shifts quickly, often through a digital platform or staffing app.
Common challenges with internal resource pools
IRPs are not without their difficulties. Many hospitals have some version of a float pool already in place, but research suggests that most do not perform as well as intended.
The most common problems include:
- Managing the pool manually, which limits its size and responsiveness
- Failing to make IRP participation attractive enough for staff to want to join
- Underutilizing IRP workers because managers default to agency calls out of habit
- Lack of technology to match available workers with open shifts in real time
Technology plays a significant role in solving these problems. Organizations that integrate their IRP into a digital workforce platform are able to automate shift posting, manage credentials, track availability, and prioritize internal staff before turning to external sources. Without this infrastructure, even a well-intentioned IRP will fall short.
Who should consider building or expanding an IRP?
An internal resource pool can benefit hospitals and health systems of almost any size, but the value is especially clear for organizations that:
- Spend heavily on agency or travel nurse labor and want to reduce that expense
- Struggle with unpredictable patient volumes and frequent last-minute shift vacancies
- Have experienced high turnover and want to retain more experienced staff
- Operate multiple facilities and want to deploy staff more efficiently across locations
- Are investing in a long-term workforce sustainability strategy
Smaller facilities may find that a formalized IRP, even a modest one, gives them meaningful flexibility without the overhead of a large-scale program. For larger systems, the financial case is often compelling enough to warrant significant investment.
Getting started: What a strong IRP requires
Building a high-functioning internal resource pool is not a one-time initiative. It requires ongoing attention to a few key areas:
- Competitive pay and scheduling flexibility to attract and retain IRP participants
- A clear credentialing and onboarding process that does not create unnecessary friction
- Technology that makes it easy for managers to post shifts and for staff to find and claim them
- Leadership buy-in and a culture that prioritizes internal resources before external ones
- Regular analysis of pool utilization, gap coverage, and cost savings to track progress
Without these foundations, an IRP risks becoming another underutilized program that fails to meet its goals. With them, it can become one of the most impactful tools in a health system's workforce strategy.
The bottom line on internal resource pools and healthcare staffing
Healthcare staffing is one of the most significant cost drivers and operational challenges facing hospitals today. At the same time, workforce shortages, clinician burnout, and the high price of external agency labor are putting pressure on organizations to find better, more sustainable solutions.
An internal resource pool addresses all of these pressures. It gives hospitals a flexible, cost-effective, and culturally aligned layer of workforce capacity that reduces reliance on outside agencies, supports clinician flexibility, and helps ensure consistent patient care.
Building and running a strong IRP takes investment and the right technology infrastructure. But for organizations that get it right, the payoff is significant: lower costs, stronger retention, and a workforce that is better positioned to meet whatever comes next.
How CareRev can help
CareRev was built to help hospitals and health systems take back control of their workforce. Our platform connects facilities with pre-qualified, local nurses and allied health professionals, making it easier to fill open shifts with trusted clinicians who already know how to work in your environment.
For health systems building or expanding an internal resource pool, CareRev works as a workforce plugin that supports your internal staffing strategy. Facilities can post shifts, manage their flexible workforce, and access local per diem talent when internal capacity falls short, all through one easy-to-use platform.
To learn more about how CareRev supports hospitals and health systems, visit carerev.com/solutions.
