Buy for one unit. Expand when it earns it.
Hospital staff scheduling software that doesn't need an RFP
Hospital staff scheduling software manages rosters across departments and units, including float pools, per-diem and agency staff, and on-call services that span facilities. Unlike enterprise workforce platforms, MedAligna is bought by a unit rather than a system: a charge nurse can sign up and publish a schedule the same day.
From $99/month per location · No sales call · No card to start
At a glance
- Hospital staff scheduling software manages rosters across departments and units, including float pools, per-diem and agency staff, and on-call services spanning facilities.
- MedAligna is bought by a unit rather than a system: a charge nurse can sign up with a card and publish a schedule the same day, with no RFP.
- Open shifts escalate through your own staff, then the float pool, then sister units, before an agency is ever suggested, and agency staff are costed at their bill rate, not an internal wage.
- Ratios with acuity, credential blocking, federal exclusion screening, and an append-only audit trail no one can edit, including the account owner.
- $149/month for a unit of up to 75 staff. Expand across the system when it has earned it.
Can a single department buy it without an RFP?
The department is the buyer. Hospital systems do not buy scheduling software; departments suffer from its absence, and then wait two years for a system to buy something.
It can, because MedAligna is priced and sold to the unit. An ICU, an emergency department, a med/surg floor or a residency programme can start on a card, publish a schedule that afternoon, and prove the thing works before anyone raises a requisition. That is not a limitation dressed up as a virtue; it is how Slack and Figma got into hospitals, and it is the only realistic route in without an enterprise sales team.
When it earns its place, it expands. Multi-location organisations, departments, units, cross-facility call services and shared float pools are all first-class from day one, so the second unit is a settings change, not a migration.
How does it handle float pools across units?
Float pools and agency spend, finally visible. A hospital's most expensive staffing decision is usually made at six in the morning by someone with no data in front of her.
MedAligna escalates an open shift through your own staff, then the float pool, then sister units, and only then suggests an agency, with agency staff costed at their bill rate rather than an internal wage, because costing an eighty-eight-dollar agency nurse at forty-five understates the gap by half. The labour ribbon on the grid moves as you fill, so the cost of a decision is visible while you are still making it.
Every fill is recorded, so the monthly question (where did the agency spend actually go) has an answer that is not a guess.
Which compliance checks will a survey ask about?
Ratios, licences, exclusions, and an audit trail nobody can edit afterwards.
Nurse-to-patient ratios computed from census with acuity weighting, licence and certification expiry that blocks rather than reminds, and federal exclusion screening against the OIG list, because employing an excluded individual costs the facility a civil monetary penalty for every item that person touches, and it is the one staffing mistake that compounds per claim.
Everything is audit-logged by the database itself, append-only, so the record exists even when the code that caused the change forgot to write it. When a surveyor asks who changed a nurse's shift on the fourteenth, there is an answer, and nobody, including the account owner, can edit it after the fact.
Which problems can a unit fix by itself?
The unit that cannot wait
The ICU's rota is a spreadsheet, and it is hurting. The enterprise workforce platform is 'on the roadmap for next fiscal year'.
The unit signs up on a card, imports its staff, and publishes a schedule that afternoon. When it proves itself, the second unit is a settings change rather than a migration.
The 6am agency call
A gap opens on nights. The charge nurse calls the agency, because that is the only phone number she has. The bill arrives four weeks later at a 38% markup.
MedAligna shows who is eligible internally (own staff, float pool, sister unit) before the agency is offered, with the cost of each option on screen while the decision is being made.
The surveyor's question
'Who changed this nurse's shift on the fourteenth, and why was she on the floor with an expired certification?'
Every change is audit-logged by the database itself, append-only. Overrides of a blocking rule carry a recorded reason and are surfaced to administrators as a distinct list.
How to evaluate hospital scheduling software
Eight questions worth asking any vendor in this category, including us. At least one of them is a question we do not answer well, and we have said so rather than leaving it out.
01Can a single department buy it?
Hospital systems do not buy scheduling software; departments suffer from its absence and then wait for a system to act. If the tool cannot be bought by the person with the problem, it will not be bought for years.
Where MedAligna lands: Yes. A unit signs up with a card, no RFP and no security review to start. Multi-unit and multi-facility are first-class from day one, so expanding is a settings change.
02Are agency staff costed at their real rate?
Costing an $88/hour agency nurse at an internal $45 understates the cost of a gap by more than half, which is exactly the number a manager is trying to control.
Where MedAligna lands: Agency staff carry a bill rate and are costed at it. The labour ribbon on the grid moves as you fill, so the cost of a decision is visible while you are making it.
03Is the audit trail editable?
An audit log that the account owner can amend is not an audit log. This is the question a surveyor's request will eventually turn on.
Where MedAligna lands: Append-only, written by the database itself rather than by application code that might forget. Nobody can edit or delete it, including us, and including your own account owner.
04Does it handle float pools across units?
The cheapest fill is almost always someone you already employ standing in another part of the building.
Where MedAligna lands: Float pools and cross-unit offers are first-class, and sit above agency in the fill order by policy rather than by preference.
05Will it integrate with our enterprise systems?
If you need scheduling to feed a system-wide workforce platform, HR system or clinical alerting stack, the integration surface may matter more than the scheduling engine.
Where MedAligna lands: We export hours to major payroll systems, generate CMS PBJ, and offer a REST API and webhooks on Enterprise. We do not have deep enterprise HR or EHR integrations. If those are hard requirements, an enterprise platform is the better fit, and we would rather tell you now.
06What is the exit cost?
Ask early. A tool that makes leaving painful is telling you how it intends to keep you.
Where MedAligna lands: Month to month, one-click export of everything to CSV or JSON, and a cancelled account goes read-only rather than dark.
What is a bill rate, a fill waterfall, or an append-only audit log?
- Float pool
- Staff deliberately unassigned to a single unit, so they can be moved to wherever the gap is. Almost always cheaper than agency and almost always invisible to generic scheduling tools.
- Bill rate
- What an agency charges the facility for a clinician's hour, as distinct from what the clinician is paid. The gap between the two is the markup, commonly 30–45%.
- Fill waterfall
- The order in which an open shift is offered: own staff, then float pool, then other locations, then agency. Most tools skip to the last step, which is where the money goes.
- Override
- A scheduler knowingly assigning someone the engine refused. Rare, sometimes legitimate, and always worth a recorded reason: an accident and a knowing exception should never look identical in an audit.
- Append-only audit log
- A record of every change that cannot be edited or deleted by anyone, including administrators. The only kind that is worth anything when someone asks what happened.
- Acuity-adjusted staffing
- Required staffing computed from how much care patients need rather than how many there are. Prevents the situation where a unit is correctly staffed on paper and short on the floor.
Questions people actually ask
- What is hospital staff scheduling software?
- Hospital staff scheduling software builds and publishes rosters across departments and units, including the parts a single-unit tool cannot see: float pools that move between wards, per-diem and agency staff, and on-call services that span facilities. Beyond a shift planner, it enforces the clinical rules (credential validity, nurse-to-patient ratios against census, minimum rest, federal exclusion screening) and keeps an audit trail of who changed which shift and when.
- What does hospital scheduling software cost?
- MedAligna is $149 per month for a unit of up to 75 staff, which is the tier most departments land on: it adds ratio and acuity compliance, payroll export and automatic generation to the $99 Starter tier. Enterprise is $249 for unlimited staff, an API and single sign-on. Three or more locations get 20% off, the trial is 14 days without a card, and every number is on the pricing page rather than behind a quote form. Enterprise platforms in this category will not tell you their price today; that is the comparison worth making.
- Who sets it up for a unit?
- The unit does, usually the charge nurse or the manager who already owns the spreadsheet. Import the staff list from a CSV, set the unit's coverage requirement and rules once, and publish. It is deliberately a job for the person with the problem rather than for a project team: no implementation, no consultant, and no security review required to start a trial. Expanding to a second unit later is a settings change, not a second setup.
- Can a single department buy this without going through IT?
- Yes. That is the design. A unit signs up with a card, imports its staff, and publishes a schedule the same day. No RFP, no security review to start, no implementation project. When it proves itself, it expands across the system: multi-unit and multi-facility are first-class from day one.
- Does it handle float pools and agency staff?
- Yes. Agency and per-diem staff are schedulable without needing a login, and agency staff are costed at their bill rate so the true cost of covering a gap is visible. Open shifts escalate through your own staff and float pool before an agency is ever suggested.
- Does it integrate with our EHR?
- MedAligna exports hours to payroll as a timesheet CSV and produces CMS PBJ files. Enterprise adds a REST API that reads your schedule, staff, credentials, open shifts and on-call chain, plus signed outbound webhooks that tell your systems the moment a shift is claimed or a swap goes through. Tell us what you need to connect and we will tell you exactly how it works.
- How does it compare to QGenda or symplr?
- On clinical rule depth, comparable. The difference is how it is bought: MedAligna is self-serve with published pricing and a 14-day trial, so a department does not have to wait for a system-wide procurement cycle to fix its own roster.
Related
Fix your unit's roster without asking anyone
Sign up, import your staff, publish. Expand across the system when it has earned it.