Facing a volatile economy, staffing agency executives assess the changing market.

(PHOTO: GETTY IMAGES/GALLO IMAGES ROOTS RF COLLECTION/ FIONA MCINTOSH)

How has the travel staffing industry changed over the past 5 years?

The evolution of the industry from 2004 to 2009 has been really interesting. I think the industry has become more accepted. Research has shown that healthcare travelers have as much if not more experience than their permanent counterparts. I think they have a lot to offer facilities based on the fact that they get experience in varied clinical settings and they gain experience adapting in new environments. I think that hospitals have realized that staffing agencies are more than a necessary evil. I think the facilities are finally seeing us as staffing partners.

The other thing that I've seen over the past 5 years is the emergence of more and more vendor-management systems. Over the past couple of years, as needs reached new heights, facilities worked with hundreds of staffing agencies and were able to effectively manage those relationships and the pool of healthcare providers through the use of vendor-management systems.

Mark Stagen

For the past 5 years, the number of healthcare staffing companies, and travel-nurse companies in general, has been growing. There seem to be more and more companies out there. And then hospitals started cutting back on the number of vendors they used and started using vendor-management systems and following tighter processes.

Jonathan W. Ward

Over the past 5 years, the industry has seen a proliferation of new companies entering the travel staffing segment. Many were in nurse staffing on a per diem basis, then began to provide full travel staffing or short-term local contracts. Since the economy has turned, that dynamic has shifted significantly. I think another thing that we have seen over the last 5 years is a significant proliferation of "intermediaries," or companies that step in between the hospital or healthcare facility and the agency. Good examples of that would be technology companies such as ShiftWise, Medefis, Symbio and other companies that purport to help hospital clients better manage their agency utilization. This technology can be disruptive to the operational flow of how agencies work with healthcare organizations.

Other intermediaries are group-purchasing organizations such as hospital associations in states such as Ohio, South Carolina, Arizona, and New Jersey; and organizations such as Broadlane which provides labor-management solutions to hospital clients. Again, it creates another layer between the agencies and the healthcare organizations, which just makes it a little bit more difficult and less efficient to serve both sets of customers. Finally, a few companies are now offering a master supplier program, where one company acts as the primary vendor and then works with other agencies to make sure all of the client's needs are being met.