Key takeaways
- At a health system in Illinois, urgent shifts that filled internally were claimed in a median of under two hours from posting. Across every shift that filled, one in six was taken within the first hour.
- The staff were not the constraint. In a survey of hospital staff who used it, 78% said they were more satisfied managing shifts than before, and the highest marks went to how easy it was to pick one up.
- The urgent window is a reach problem before it is a willingness problem. When the shift gets in front of the right people, a meaningful share say yes, and quickly.
There is a belief inside most hospitals that nobody wants the last-minute shift. It posts, the phone tree runs, nothing comes back, and one of two things happens: the conclusion is that the staff were not interested, or the incentive goes up at the last minute, which teaches everyone to wait. The 90-day data says something different. When an urgent shift actually reached the people who could take it, the answer came fast.
What happened when the shift got through
Over 90 days across three departments, 349 shifts posted with less than 24 hours’ notice. Most did not fill internally; we wrote about why in Hospitals Have Two Open Shift Problems. They Manage Them Like One. But 40 of them did, and the speed of those 40 is the finding worth sitting with.
The median time from posting to acceptance on those urgent shifts was under two hours. Across all 361 shifts that filled, at any lead time, one in six was claimed within an hour of distribution. A shift that historically sat open for days was, once it reached staff on their phones, often gone before the next huddle.
That is not what a reluctant workforce looks like. It is what a workforce looks like when the offer finally reaches it.
The people were there all along
At the end of the study, participating staff were surveyed. Twenty-seven responded, so read the figures as a signal rather than a census, but the direction is not ambiguous. Seventy-eight percent said they were more satisfied managing shifts than before. The average overall rating was eight out of ten. The highest marks went to ease of pickup.
Two of the responses, from employees at the hospital:
“It’s easier to plan ahead as a PRN employee and know when shifts are needed that I can pick up to help.”
“I like being able to see the exact incentive offered as well as what shifts are available. Being able to pick up partial shifts is also beneficial.”
Neither of those is about money first. Both are about visibility: knowing what is open, what it pays, and being able to say yes to the piece of it that fits. That matches what the broader workforce has been saying for years. In AMN Healthcare’s 2025 survey of registered nurses, 81% said flexible scheduling would improve their work-life balance, and only 39% said they planned to keep working the way they are now.
Adoption told the same story. Sixty-four percent of active users logged in without any training. Every employee who logged in once came back. Nobody had to be convinced to look for shifts. They had to be given a way to see them.
What it means for the urgent window
The instinct when a last-minute shift is not filling is to assume the people are not there. The data says the people are there, and that the process of asking is what fails: a charge nurse with a phone reaches a handful of names, most of whom cannot make it in time, and the shift goes outside before anyone else ever hears about it.
Reach first, then everything else. Once the urgent shift is in front of every qualified employee at once, the hospital can find out what it actually takes to fill it. Sometimes that is a premium, and the incentive data shows where a premium works. Sometimes it is simply the first person free that afternoon.
The response is not uniform across roles, and that matters for how a hospital sets policy. In this study, respiratory therapy filled 48% of its urgent shifts. Registered nurses filled 10.6%. Patient care technicians filled 5.5%. The urgent-shift problem is concentrated, not universal, which means the fix should be set by role and by unit rather than across the building. We covered the visibility argument before the study in Coverage Isn’t Missing. Visibility Is. The study put numbers on it.
Where we come in
Gigly is how the Illinois system got the urgent shift and incentive in front of its own people. Employees see open shifts on their phones and pick them up, before those shifts turn into overtime or agency. The two-hour median above is what that looks like on a real unit. By 90 days, staff had picked up 361 shifts and about 3,700 hours of care that did not go outside.
If you want to know whether your staff are the constraint, look at the urgent shifts that did fill over the last 90 days and check how long each one sat open before someone took it. If the answer is hours rather than days, the willingness was never the problem. We are glad to walk through it with you.
Frequently Asked Questions
How fast did urgent shifts fill when they filled?
In this study, the median time from posting to acceptance on shifts with less than 24 hours’ notice was under two hours. One in six of all filled shifts, at any lead time, was claimed within the first hour.
If staff are willing, why do most urgent shifts still go unfilled?
Because most of them never reach the people who could take them in time. A phone list reaches a few names; a posting every qualified employee sees on their phone reaches all of them. Nearly 90% of urgent shifts in this study went unfilled internally, and reach, not willingness, is the gap the data points to.
Does this hold for every role?
No. Respiratory therapy filled 48% of its urgent shifts; registered nurses 10.6%; patient care technicians 5.5%. The urgent-shift gap is concentrated in specific roles, which is why the fix should be set by role and by unit.