How a Multisite Academic Health System Achieved a 93% Per Diem Fill Rate 

At a glance

• Since 2018, Aya and a multisite academic health system have built a trusted per diem partnership. 
• In 2025, the program filled 23,070 shifts with a 93% fill rate. 
• Through September 2026, the program had filled 22,716 additional shifts across clinical, nonclinical and outpatient settings. 

The challenge

A West Coast, multisite health system needed a more productive and responsive approach to per diem staffing.

The health system had to respond to changing census levels, shifting patient demand and staffing needs across multiple facilities and specialties. It also needed a partner willing to adjust as those needs changed.

In 2018, the health system partnered with Aya to build a more effective per diem program.

Results

The program has consistently outperformed the national benchmark.  

In 2025, Aya filled 23,070 of 25,293 requested shifts, achieving a 93% fill rate. Through September 2026, the program has filled 22,716 additional shifts. 

The program’s scale extends beyond its fill rate. Aya supports per diem coverage across clinical, non-clinical and outpatient settings, giving the health system a flexible source of coverage across a broad range of needs. 

More than bedside coverage

Per diem workers use the Shifts app to claim available shifts across nursing, CNA assignments, imaging, pharmacy and medical assisting.  

The program also supports the operations that keep the health system running, including food and nutrition, meal and tray delivery, environmental services and custodial support. Coverage reaches outpatient locations, cancer infusion centers and other smaller facilities, with CNAs supporting needs such as patient transport. 

As the health system’s needs have changed, the program has expanded into nonclinical services and labor and delivery, with potential future expansion into radiology and other areas.  

A partnership built on trust

The program’s longevity depends on more than filling shifts. It depends on the trust between Aya and the health system’s staffing office. 

Aya’s team works closely with health system leaders to understand where coverage is needed and adjust the approach as conditions change. Over nearly a decade, the teams have refined the program through shared problem-solving, including through the COVID-19 pandemic.  

The partnership also helped the health system respond to seven labor strikes, using its established per diem program to provide coverage during periods of workforce disruption. 

That level of trust gives both teams the flexibility to test new approaches, learn from the results and keep improving the program. It also allows Aya to provide dedicated, hands-on support built around the health system’s needs.  

Data-informed coverage across the health system

Behind the program is a daily view of incoming census, scheduled travelers, local staff and shift-level coverage. Aya and the health system teams use those patterns to anticipate demand and make better decisions about where per diem coverage is needed. 

This combination of shared data, local knowledge and close coordination helps the program adapt as needs change. 

Built for what’s next

The program continues to evolve because Aya and the health system have built more than a staffing arrangement. They have built an operating partnership grounded in trust, shared data and a willingness to adapt.

The result is a per diem model that supports the many facilities, specialties and operations that keep the health system moving, with room to expand as its needs change.