Almost no ED runs entirely on its core, full-time staff. There are vacations, parental leaves, a sudden resignation, a flu-season surge, a new site that is not yet fully staffed — and the people who plug those holes are your PRN and per-diem physicians and, when the gap is bigger, locums. Getting that flexible layer of coverage onto the schedule cleanly is its own discipline, and it is one most scheduling tools handle badly.
This is how to think about scheduling the flexible workforce in the ED: filling gaps, handling availability that changes week to week, keeping it fair between your core and your PRN staff, and making sure the right person is eligible for the right shift at the right site.
PRN (as-needed), per-diem (by-the-day), and locums physicians exist to absorb variability. The catch is that the very flexibility that makes them valuable also makes them hard to schedule:
The old way to fill a gap is a flurry of texts and a phone tree: the coordinator messages people one at a time until someone says yes. It is slow, it is opaque, and it tends to favor whoever happens to answer first rather than spreading the work sensibly.
The better model is the open shift. The uncovered slot is posted, eligible providers can see it, and they can claim it themselves. The coordinator stops being a switchboard and becomes an approver. This is faster for everyone and far more transparent — the people who want extra work can see what is available and grab it without a back-and-forth.
Fairness with a flexible workforce cuts two ways, and both matter.
On one side, you do not want a desirable open shift to vanish to whoever refreshed their phone first while a reliable PRN who wanted it never got a look. On the other, you often have targets for your PRN staff — a number of shifts per period you have agreed to offer them, or that they have committed to working — and those targets should actually be honored rather than forgotten. The flexible layer should not be a free-for-all on one end or a neglected afterthought on the other.
This is the constraint that turns into a compliance problem if you ignore it. A locums physician credentialed only at your main campus must never be schedulable at the satellite. A PRN doc cleared at two of your three sites should only ever see open shifts at those two. Eligibility cannot be a sticky note in the coordinator's memory — it has to be a property of the provider that the system enforces every time, especially in a multi-site group sharing one pool of people.
Your flexible workforce is, by definition, not in the building most of the time. If they cannot view their schedule, see open shifts, and set their availability from their phone, the whole arrangement falls back to texts and email. Mobile access is not a nice-to-have for this group — it is the channel.
| Need | What to look for |
|---|---|
| Filling gaps fast | Open shifts that eligible providers can see and claim themselves, instead of a one-by-one phone tree. |
| Variable availability | Self-service availability each provider sets from their phone, so you are working from current information. |
| Fair core/PRN balance | PRN targets that the schedule actually honors, plus visibility so desirable shifts are not won by reflexes alone. |
| Credential / site eligibility | Per-provider site eligibility the system enforces, so no one is offered a shift they cannot cover. |
| Mobile-first access | Schedule, open shifts, and availability all reachable from a phone with nothing to install. |
CoverED is built around one shared provider pool, which is exactly the shape a group with core, PRN, per-diem, and locums staff needs. Each provider carries their own site eligibility, so people only ever see and claim shifts at the locations they are cleared for. When a gap appears, you post it as an open shift; eligible providers see it on their phones and claim it themselves, and you approve — no phone tree.
Availability is self-service: every provider sets theirs from their phone, so you are always scheduling against current information rather than last month's assumptions. CoverED also supports PRN targets, so the number of shifts you have agreed to offer your as-needed staff is something the schedule works toward rather than forgets. The whole thing is a mobile-friendly web app — your flexible workforce checks schedules, grabs open shifts, and sets availability from anywhere, with nothing to download and calendar sync over ICS/webcal. And because I built it as a practicing EM physician, the fairness between your core and your flexible staff is treated as the point, not a footnote.
CoverED was built by an EM physician for EM groups — fair generation in minutes, night/weekend/holiday equity, phone-based requests and trades, and multi-site coverage. I'll even personally onboard your group and configure your exact rules for you. There's a free, no-risk trial, and founding groups lock in 50% off for life. See it in action →