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How do you deploy flexible workers during staff shortages?

Stéphanie van Rosmalen ·
Verpleegkundige in scrubs bekijkt tablet bij verpleegpost in verzorgingshuis, lege stoel op de voorgrond symboliseert personeelstekort.

When facing a structural staff shortage, flexible workers are most effective as a supplement to a permanent core team — not as a replacement for one. Think of temporary agency workers, on-call staff, and freelancers who step in during peak demand, illness, or seasonal busy periods. For healthcare organizations, it is also worth exploring AI solutions that structurally reduce workload. This article covers the most important questions around flexible staffing in healthcare.

What types of flexible workers are available in healthcare?

In healthcare, there are four commonly used forms of flexible workers: agency staff, on-call workers (with or without zero-hours contracts), freelancers, and employees hired through a payroll company. Each type differs in terms of availability, cost, and legal obligations for the employer.

It is important to understand what each type involves before making a decision:

  • Agency staff: Supplied through a staffing agency. Quick to deploy, but typically more expensive per hour. Best suited for short-term solutions.
  • On-call workers: Employees with a min-max or zero-hours contract who are called in as needed. Flexible, but availability is not guaranteed.
  • Freelancers: Self-employed professionals with their own rates and expertise. Often deployable for specialized tasks or when regular agency staff are unavailable.
  • Payroll employees: Legally employed by a payroll company but working in practice for your organization. Offers more continuity than agency work, with less administrative burden.

In elderly care and hospitals, internal flexible pools are also becoming increasingly common: staff members who rotate across multiple locations within the same organization. This improves care quality because the employees already know the organization and its residents.

How do you effectively deploy flexible workers during a structural staff shortage?

Effective use of flexible workers during a structural staff shortage requires a clear structure: a permanent core team that maintains continuity, supplemented by flexible staff who fill specific gaps. Without that structure, flexible deployment quickly leads to higher costs, lower quality, and burned-out permanent employees.

Practical steps for integrating flexible workers effectively:

  1. Map out the bottlenecks: When and where do shortages occur? Are they structural or incidental? This determines which type of flexible worker is most appropriate.
  2. Establish clear onboarding protocols: Flexible workers have less time to get up to speed. Short, clear instructions and a dedicated buddy significantly accelerate their readiness to work.
  3. Build your own flexible pool: Staff who are already familiar with your location and residents are far more effective than constantly introducing new faces. Invest in retaining flexible workers who are a good fit.
  4. Plan proactively, not reactively: Do not wait until a shift is understaffed. Use scheduling software that flags shortages early so you can make adjustments in time.
  5. Communicate transparently: Make sure flexible workers know what is expected of them, and that permanent staff see them as support rather than a threat.

What are the advantages and disadvantages of flexible workers in elderly care?

Flexible workers give elderly care organizations the ability to respond quickly to fluctuating staffing levels, but they also carry risks for care continuity and the workload of permanent staff. This is a trade-off every organization must consciously consider.

Advantages of flexible deployment

  • Quick response to illness, leave, or unexpected busy periods
  • No long-term contractual obligations during temporary peaks in demand
  • Access to specialized knowledge that is not always available in-house
  • Relief from workload pressure for permanent staff

Disadvantages of flexible deployment

  • Higher cost per hour worked compared to permanent employees
  • Less continuity for residents, which carries particular weight in elderly care
  • Additional coordination and onboarding time for managers
  • Risk of quality loss if flexible workers are insufficiently familiar with residents and protocols

In elderly care, the relationship between staff and residents is a core component of care quality. Too much turnover of faces can cause distress among residents, particularly those living with dementia. This makes it especially important to limit flexible deployment to a supplementary role — not the foundation of your staffing policy.

Can AI (partially) compensate for staff shortages in healthcare?

Yes, AI can offset part of the staff shortage in healthcare by taking over tasks that currently demand a great deal of time and attention from care workers — such as nighttime monitoring, patient safety surveillance, and detecting at-risk situations. AI does not replace caregivers, but it significantly reduces workload.

In practice, this means AI systems enable care workers to focus their attention on tasks that require human contact and professional expertise, rather than on continuous monitoring. This is especially valuable at night, when staffing levels are lowest and the risk of undetected incidents is greatest.

Concrete applications of AI in healthcare include:

  • Automatic detection of fall incidents, so staff are alerted immediately
  • Monitoring of lying positions to prevent pressure sores
  • Early detection of unsafe situations without requiring a staff member to be continuously present

AI does not fully resolve staff shortages, but it enables organizations to deliver a higher standard of care with the same number of staff — or even fewer.

When is it better to invest in technology than in additional staff?

Investing in technology makes more sense than hiring additional staff when the staff shortage is structural, the labor market remains tight, and the tasks you want to support are repetitive and measurable. For incidental shortages or tasks that require human judgment, staff remain the better choice.

Ask yourself the following questions to inform the decision:

  • Is the shortage temporary or structural? In cases of structural scarcity, technology offers a more sustainable solution than continually hiring expensive flexible workers.
  • Which tasks take up the most staff time without requiring direct human contact? These are the best candidates for automation.
  • What are the total costs? The investment in technology must be weighed against the long-term costs of flexible hiring, including coordination and quality risks.
  • What is the impact on employee well-being? Technology that reduces workload also helps retain existing staff.

In elderly care and hospitals, demand for care is growing by an average of six percent per year, while the availability of healthcare staff is not keeping pace. In structural situations like these, technology is not a luxury — it is a necessary complement to your staffing policy.

How Kepler Vision Technologies helps address staff shortages in healthcare

At Kepler Vision Technologies, we develop AI software that helps healthcare organizations deliver safe, high-quality care with fewer staff. Our solutions are specifically designed for elderly care facilities and hospitals dealing with structural staff shortages.

Here is what our software does in concrete terms:

  • 24/7 monitoring of residents and patients, including at night and in the early morning when staffing levels are lowest
  • Immediate fall detection with an alert within seconds, so staff can intervene without delay
  • Exceptionally low false alarm rate: just one false alarm every 92 days, which drastically reduces workload compared to older technologies
  • Privacy-first approach: footage is never viewed by humans, meeting the strictest privacy standards
  • Plug-and-play installation: easy to plan, configure, and deploy in existing care environments

Our software enables care workers to focus on what truly requires human contact, while the AI handles monitoring. This allows your organization to meet growing care demand without proportionally increasing headcount. Want to find out what our solution can do for your organization? Get in touch with us and we would be happy to think it through with you.

Frequently Asked Questions

How many flexible workers can you responsibly deploy relative to your permanent team?

A commonly used guideline in healthcare is that flexible workers should make up no more than 20 to 30 percent of total staffing. Above that threshold, care continuity noticeably declines and the coordination burden on managers and permanent staff increases. When determining the right ratio for your organization, also consider your resident population: for residents with dementia, a lower proportion of flexible staff is strongly recommended due to their need for familiar faces.

What are the most common mistakes when deploying flexible workers in elderly care?

The most common mistake is reactive planning: only calling in additional staff once a shift is already understaffed, leaving no time for a proper handover or onboarding period. A second frequent mistake is the absence of a standardized onboarding process, meaning every flexible worker has to figure things out from scratch. Finally, organizations often underestimate the impact on permanent staff, who — when flexible workers are deployed on a structural basis — must repeatedly guide and onboard new people, leading to additional workload and burnout.

How do you build an internal flexible pool, and where do you start?

Start by identifying employees within your organization who are willing and able to work across multiple locations or departments. Offer them an attractive contract — such as a min-max contract with a guaranteed minimum number of hours — so they are not dependent on an external agency. Then set up a central scheduling system where these employees can submit their availability and managers can respond quickly. A well-functioning internal pool reduces dependence on expensive external agencies and improves care quality because the staff already know the organization.

What privacy regulations apply to the use of AI monitoring systems in care facilities?

AI monitoring systems in healthcare must comply with the GDPR (General Data Protection Regulation) and the specific guidelines issued by national data protection authorities regarding the use of camera systems in care facilities. It is essential that residents and their representatives are informed about the use of the technology, and that there is a clear legal basis for processing image data. Systems that — like those from Kepler Vision — never allow images to be viewed by humans and operate using anonymous image processing generally meet the strictest privacy standards, significantly lowering the barrier to implementation.

How do I convince my management or board to invest in AI solutions?

Make the business case concrete by mapping out the current costs of flexible hiring, coordination time, and quality incidents, and comparing these against the investment in technology. Demonstrate that AI not only saves costs but also contributes to employee satisfaction and the retention of existing staff — two factors that have a significant indirect financial impact. Pilot projects at a single location or department are a low-threshold way to build internal support with measurable results before discussing a broader rollout.

Can AI systems be used during the day, or are they only useful at night?

AI monitoring systems are also valuable during the day, but their added value is greatest at night and in the early morning, when staffing levels are lowest and the risk of undetected incidents is highest. During the day, the same systems can help reduce unnecessary check rounds, freeing up staff time for direct care and human interaction. Their use is therefore complementary to the daily care process — not limited to any one specific time of day.

What can I do to retain flexible workers in my organization for longer?

Flexible workers often disengage because they do not feel connected to the organization. Small adjustments can make a significant difference: include them in team meetings, assign them a dedicated point of contact or buddy, and ensure they have access to the same information and protocols as permanent staff. Also consider actively offering strong-performing flexible workers a permanent position — the ongoing costs of recruiting and onboarding new faces are structurally higher than investing in retaining familiar, proven employees.

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