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In a recent Amergis webinar, three industry experts challenged a mindset that quietly costs hospitals more than they realize. Kayla Walck, RN and Director of Clinical Operations, moderated a conversation with Josh Gaw, VP of Commercial Strategic Sales, and Roman Murdakhayev, Director of Nursing at Westborough Behavioral Health Hospital. Their shared message was simple: treat agency staffing partnerships as a strategic, ROI-driven lever that can help actively protect revenue while keeping your operation moving. When you plan for it, supplemental staffing goes from being a stopgap to behaving like an investment.

Most leaders are often forced into the same situation with supplemental staffing: a bed sits empty, a shift goes uncovered, and someone scrambles to plug the gap. This forced reactivity often becomes a stressor on your team and leadership, while quietly draining your budget. Consider these five recommendations when working with a strategic staffing partner.

1. Reframe supplemental staffing

Walck opened the discussion with what the state of behavioral health staffing looks like today: unstaffed beds, teams stretched thin, margins under strain. The fix is not another panic order. It is a shift in how you think about the spend in the first place. As Gaw put it, staffing becomes a strategic lever when it is clearly defined operationally and financially. Not when it is grabbed in a crisis.

Murdakhayev pushed the point further, urging leaders to move beyond traditional staffing models. That means leaning on flexible and hybrid approaches, building an internal growth pipeline, recruiting and planning earlier, and easing the reliance on full-time staff. A certain share of the workforce will involve contractors no matter what, so the goal is to plan for that reality rather than react to it. He emphasized that staff want flexibility, growth, and opportunity. When people feel like they belong or see a future, they are more likely to stay.

2. Diagnose the real workforce problem

When a unit feels short, the instinct is to ask for a number. “I need five nurses.” But Gaw argued that the number is the wrong starting point. The real question is, “what is the operational problem you are trying to solve.” He walked through four areas worth diagnosing first:

• Workforce stability. Are you facing chronic vacancies, seasonal swings, or a short-term disruption?
• Operational risk. Are unstaffed beds, safety concerns, or regulatory pressure driving your urgency?
• Financial leakage. Are overtime, burnout-driven turnover, and onboarding churn costing more than agency support would?
• Strategic goals. Are you trying to stabilize, grow census, reduce burnout, or build a pipeline toward permanent hires?

Once you have visibility into these challenges, the right staffing partner can structure solutions to combat them. The point is to be intentional, matching the model to the problem rather than to whatever looks good on paper. Per diem covers call-outs and census spikes. Contract assignments deliver predictable coverage and relieve your core team. Temp-to-perm gives you a try-before-you-buy window of three to six months. Dedicated programs behave more like an internal float pool.

3. Integrate agency clinicians into your culture

A stubborn stigma still follows contingent labor around. Murdakhayev offered a refreshingly plain antidote. Treat agency staff like outsiders, and they will carry themselves as outsiders. Treat them as part of the team, and they will feel supported enough to engage, extend contracts, and contribute to a better workplace experience. He has watched permanent staff morale rise simply because agency clinicians were welcomed in and held to the same expectations as everyone else.

From her days working with clients, Walck noted that cultural inclusion drives better outcomes, and the right staffing partner helps enable it. She has hired travelers into permanent roles, some into management, precisely because they had already proven themselves inside the culture.

Whether you like it or not, agency clinicians become extensions of your hospital’s culture, operations, and patient experience. That is why screening and role alignment carry so much weight. The right fit is not just a matching set of credentials. It is the person who fits your setting, your acuity, and your team. Get that wrong, and the cost compounds: culture frays, performance slips, and patient safety can suffer. Get it right, and that clinician is positioned to deliver stronger care and stay longer.

4. Measure ROI beyond the bill rate

The hourly rate is only one part of the picture. Many clinical leaders already know agency support pays off, but the hard part is translating that conviction into numbers a finance partner will accept. Walck noted that some CFOs do not want to hear about indirect costs. But those costs do not disappear just because they go unspoken. Murdakhayev framed the financial decision through two lenses: what you could lose by leaving a need uncovered against what you could spend to fill it with the right person. Consider that replacing a nurse costs about $56,000 per RN. Set that against the price of stabilizing the unit, and the math shifts. One study estimated that lower nurse turnover rates translate to $313,000 in cost savings per every 100 nurses.

True ROI comes from reduced overtime, lower turnover, protected census, improved safety, and steadier operations. Gaw described how the strongest staffing partners assess return across all of these fronts instead of a single line item.

5. Build a high-performance partnership

Strong partnerships start with clear communication and shared expectations. The right partner understands your acuity and orientation needs, responds quickly, and consistently delivers both speed and quality. Murdakhayev was blunt on that last point: a fast shift filled by the wrong person creates more problems than it solves. Gaw agreed, pointing to three factors that help with this:

• Proactive recruiting. Pipelines of behavioral health nurses, techs, and specialists get built before an order ever lands, so qualified people are ready when needs arise.
• Expert screening. Behavioral health calls for de-escalation skills, trauma-informed care, and high-acuity experience, not just a license on file.
• Operational infrastructure. Credentialing, compliance, and onboarding are built to move fast without cutting corners, with clinical oversight protecting quality.

When these systems work together, you get clinicians aligned to your facility rather than warm bodies filling slots.

The takeaways

Murdakhayev said it best, closing with these five considerations:

1. Choose a partner who understands you and your setting, acuity, culture, and expectations.
2. Make orientation clear and consistent for every clinician who walks in.
3. Establish strong communication channels from day one.
4. Hold your staffing partner accountable for both quality and fit.
5. Measure ROI broadly, including overtime, turnover, morale, safety, and burnout.

Remember, supplemental staffing rewards leaders who plan for it and use it purposefully. Do that, and your staffing relationships will feel less transactional and more like a true partnership.

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