A float pool is a group of clinicians who are already credentialed at your urgent care and have agreed to be offered open shifts before you look anywhere else. It covers the gaps a permanent schedule leaves: vacations, call-outs, the Saturday nobody on staff wants.
This guide covers what separates a float pool from a contact list, how to work out whether one saves you money, and how to recruit, credential, size and maintain it.
What an Urgent Care Float Pool Is
Most clinics already have an informal version: a few names the manager texts when a shift opens. A float pool differs from that list in four ways.
- Everyone in it is cleared before they're needed. Credentialing is finished, EMR access exists and orientation is done.
- Availability is stated. Each member has told you which days, shift lengths and notice periods they'll consider.
- The terms are set. Rates for standard, weekend and short-notice shifts are written down, along with how and when members are paid.
- Someone owns it. One person keeps the roster current, sends the offers and tracks who's working.
Without all four, you have a list of people who might be able to help. The pool can include every role you schedule: physicians, NPs, PAs, RNs and MAs.
What an Urgent Care Float Pool Costs and What It Saves
The saving comes from covering a shift with a clinician you engage directly when you'd otherwise pay an outside source for it. To see whether that saving is real for your clinic, compare two numbers for the same shift.
The first is what the outside source bills you per hour. The second is your full hourly cost of a pool clinician: their rate plus everything you now carry yourself. That can include malpractice coverage, payroll taxes or contractor administration, credentialing work and the coordinator's time.
Annual saving = (outside bill rate minus your full pool cost per hour) × hours per shift × shifts moved to the pool
Use your own invoices and your own cost figures. The result can be small or negative for a clinic that moves only a few shifts a year, because the fixed work of credentialing and maintaining a pool doesn't shrink with volume.
An agency or a marketplace also does things a float pool can't. It recruits beyond the people you already know, and it reaches clinicians in the weeks when your pool is on vacation along with your staff. A pool replaces an outside source for part of your coverage, so plan to keep one for the rest.
How pool members are engaged, as per diem employees or as contractors, affects tax, overtime and malpractice arrangements. That's a question for your employment counsel and your accountant, and their answer belongs in the cost figure above.
Who Belongs in an Urgent Care Float Pool
A float pool needs clinicians who want an ongoing, occasional relationship with one clinic. Three traits matter most:
- They live close enough to take a shift on short notice.
- Their open days overlap the windows you struggle to fill.
- They'd choose returning to a clinic they know over starting somewhere new.
Places to look:
- Clinicians who've already worked shifts at your clinic. Read your staffing agreements first. Some restrict engaging a clinician directly for a period after a placement, and your counsel can tell you what yours allows.
- Former staff who left on good terms, and part-time staff who want more hours.
- Referrals from your current clinicians and your medical director.
- Clinicians who've picked up one of your posted shifts and said they'd come back.
Say what you're recruiting for. "We want people who'll take occasional shifts, some at short notice" draws different candidates than a posting for scheduled coverage.
Credential Float Pool Clinicians Before You Need Them
A clinician who's interested and nearby still can't work tomorrow's shift if their file isn't complete. Credentialing has to be finished for every member before the first request goes out. That means doing the work for people who may cover only a few shifts a year.
What the file contains depends on the role, so set a checklist for each clinician type instead of applying the physician checklist to everyone. Track every expiration date, including licenses, certifications and insurance, and start renewals early enough that nobody drops out of the pool unnoticed.
Credentialing clears the person. Orientation prepares them for your clinic. A pool member who hasn't worked with you in months needs the same packet a new locum gets, and urgent care locum orientation covers what goes in it.
How to Size an Urgent Care Float Pool
Pool members have other commitments, so any one of them will decline some requests. The size you need depends on how often they say yes.
If each member accepts a given request with probability p, and their availability is independent, the chance that at least one of n members accepts is 1 minus (1 minus p) raised to the power n. Suppose each member says yes to 30% of requests. With four members, the chance that someone accepts is 1 minus 0.7 to the fourth power, or about 76%. With eight members it's about 94%.
The 30% is an illustration. Replace it with your own acceptance rate once you've sent a few dozen requests.
Availability also isn't independent on the dates that matter most. Holidays and school breaks take out much of a pool at once, so those dates need commitments made well ahead. Size by role as well, since eight physicians don't help when the MA calls out.
Running the Float Pool: One Roster and an Ask-First Rule
Keep the roster in one place, with each member's role, clearance status, expiration dates, stated availability and shifts worked. If you run more than one site, record clearance per site. Multi-site urgent care staffing covers how that roster works across locations.
Then set one rule: every open shift is offered to the pool first, for a fixed period, before it goes to an outside source. Send each request to all eligible members at once so nobody waits on a serial phone list. Without the rule, whoever fills gaps under time pressure goes back to the channel they used last time.
Track four numbers each month: shifts offered to the pool, shifts the pool filled, each member's acceptance rate and the time from request to confirmation. Those tell you whether the pool is working and feed the sizing math above.
Paying Float Pool Clinicians
Pay a rate that holds up against what the same clinician could earn for the same shift elsewhere. If the pool's saving depends on paying less than that, members will take their open days to whoever pays more.
Publish the differentials for weekend, evening, holiday and same-day shifts so nobody negotiates each request. Pay on the schedule you stated. A clinician working directly with a clinic has no agency to chase a late payment for them, so a missed pay date lands on them directly and gives them a reason to stop answering.
Keeping an Urgent Care Float Pool Active
A pool that's only contacted in emergencies stops answering. Offer members scheduled shifts in advance as well as short-notice ones, so they hold days for you.
Expect attrition. Members move, change jobs or take permanent roles, so recruit for the pool on a regular schedule instead of when it has already shrunk. If the share of shifts the pool fills drops, check two things: whether members are declining more often, and whether open shifts are reaching the pool before they go outside.
A Build Order for an Urgent Care Float Pool
- Count last year's open shifts by role, day of week and notice given. Walk-in volume forecasting shows where next year's are likely to fall.
- Run the cost comparison with your own figures and decide which shifts the pool should take.
- Have counsel and your accountant settle how members will be engaged.
- Write the rate card, the pay schedule and the ask-first rule.
- Recruit a first group and finish their credentialing and orientation.
- Route advance-notice gaps to the pool first, then short-notice ones as it deepens. The same-day call-out playbook covers how the pool is used on the morning a shift opens.
- Review the four monthly numbers and resize.
The credentialing step is the one that can't be skipped or reordered. A list of interested clinicians who aren't yet cleared can't cover a shift.
Rediworks is a self-service marketplace for urgent care locum shifts. For the shifts your float pool can't cover, you post the clinician type, dates and shift details yourself. Sign up to post shifts.