Use case: healthcare staffing·

From worked shift to pay and invoice,
made agentic.

Shift, pay and invoice.

A use case from healthcare staffing: the weekly process from worked shift to pay and invoice. We follow one example firm that places nurses and carers in care institutions, from the process it runs today to a version where agents do the routine work and people keep the decisions.

Published by Aitonomy We put AI to work in companies. This is where we write down what that actually takes. What we do →

Every worked shift at a staffing firm becomes a timesheet. Each one has to be approved by the client, checked against that client’s pay rules, paid and invoiced. At a firm with 1,200 shifts a week, most of that work is still done by hand, and most of it lands in the two days before payroll.

This piece shows how that process becomes agentic: agents do the routine steps, and people keep the decisions. We follow one example firm, Example Care Staffing, from the process it runs today to an agentic version that runs every week and keeps improving.

In short: you describe the process in a conversation with Aito, the assistant in the Aitonomy app. Aitonomy draws the process, designs the agents for it automatically, and shows you what they do, use and cost.

About this example

Example Care Staffing is not a real firm. It is built from our research into 66 Dutch staffing firms. The process is the one these firms describe in their own job adverts and sector sources. The numbers are example figures, and the result shows how we calculate them.

3 days → same day

From worked shift to approved hours

9 in 10

Timesheets that no longer need a person

120 → 30 h

Office hours on timesheets each week

Example figures for a firm with 1,200 shifts a week.
Two screens. On a phone, Aito, the assistant, asks what the operations director wants to hand over; she answers by voice: our hours, from worked shift to payroll and invoice. Aito asks which systems and people are involved: AFAS and Assist Planner are connected, Sanne and Daan are invited, and 46 team leads take part through the client portal. Beside it, the process page for hours to pay and invoice, ready to go live: process drawn with 6 steps and 3 roles, agents designed for 4 steps, tested on 8 past weeks. The six steps show who does each: read the hours, get approval, check client rules and prepare payroll by an agent, release payroll by Sanne in payroll, invoice clients after approval.
From one conversation to a running process. The operations director describes the process to Aito by voice. Aitonomy draws the process, designs the agents and tests them. Example screens.

The problem: Thursday is payroll day

Example Care Staffing places 600 nurses and carers in 70 elderly and disability care institutions. Every shift produces a timesheet, so the office handles about 1,200 timesheets a week.

Each timesheet goes through the same steps. The institution approves the hours. The office checks them against that client’s rates and break rules. Payroll pays them on Thursday. Finance invoices the client and writes the self-billing invoice for self-employed professionals.

The work waits in one place above all. Team leads at the institutions approve late, so on Wednesday the planners phone them one by one. Whatever is still open on Thursday morning is paid late, or paid wrong and corrected the week after.

The rules are getting heavier. Since January 2026, the staffing collective agreement requires pay of equal value to each client’s own staff, so every client’s terms must be collected and applied. Under the new admission law for staffing firms, the Wtta, hours records and invoices become evidence a client relies on.

The hours process today in three lanes. The professional enters hours in an app or on paper. The client approves them in a portal or by mail. The office chases approvals by phone, which waits two days, checks client rules at about six minutes per timesheet, pays on Thursday, invoices clients and keeps the evidence file. 1,200 timesheets and 120 office hours a week.
The process today. Approval waits on the client, and the office spends Wednesday chasing it.

What AI can do in this process now

Most steps in this process are reading, checking and chasing. Those are the steps an agent can take on today.

Read every timesheet. An agent reads hours from the professionals’ app, from a scanned paper form or from an email.

Get the approval. It asks the team lead to approve in their own channel, and reminds them before payroll closes.

Check against the client’s rules. It checks each timesheet against that client’s rates, irregular-hours pay and break rules, and flags what deviates.

Prepare payroll and invoices. It prepares the payroll batch, the client invoices and the self-billing invoices, and keeps the evidence file complete.

People keep the decisions. A correction above a set amount, releasing payroll, sending invoices and any dispute with a client stay with the team.

The same process, agentic. The agent reads the hours, reminds clients, checks client rules and keeps the evidence file. The client approves with one tap. Sanne in payroll releases payment on Thursday. Invoices go out after approval.
The same process, agentic. The agent reads, chases, checks and keeps the file. Payroll is released by a person, and invoices go out after approval.

What others have achieved

Few staffing firms publish measured results on this part of their work yet. The clearest numbers we found point the same way: the work is large, errors are common, and automating it pays.

−68%

Hours spent on 4,000 timecards a week at AMN Healthcare, a US healthcare staffing firm, after it automated the work

1 in 5

Payrolls contain errors, at $291 per error on average. Time records cause the most

10%

Staffing firms that run agentic AI across their whole workflow in 2026

Sources: AMN Healthcare, an earlier automation project reported by its software vendor; an EY survey of 508 payroll professionals, commissioned by Paycom (2022); Bullhorn GRID 2026, a survey of about 2,300 staffing professionals.

The AMN result came from rule-based automation, before today’s agents. Agents can also handle the cases rules cannot: a scanned form, an unclear email, a client with its own terms. And most staffing firms have not yet applied agents to this work.

Start from the process you have

If you designed this process from scratch with AI, it would look different. Steps would merge, and there would be less waiting.

Getting there in one move means a long change before anything runs. We start from the process your team runs today, and make each step agentic where an agent can do it well.

You see the benefit within weeks. The people in the process keep working the way they know, with less routine work on their desk. From there, the process improves step by step.

Two ways to an agentic process. Starting from the process you run today: agentic steps live within weeks, then improving step by step, towards an AI-native process. Redesigning from scratch: a new design on paper first, then a long change before anything runs, and an AI-native process months later.
Start where you are. The first agentic steps run within weeks, and the process keeps improving from there.

How it works

You explain how the process works today and what success looks like for you, in a conversation with Aito, the assistant in the Aitonomy app. From there, two designs are made, one after the other.

The process design. A complete picture of the process as it runs today: every participant, every step, the tools, the rules and the way of working. It is drawn just by asking you and your team questions.

The agentic design. Aitonomy makes the process agentic automatically, on top of the process design. Before it runs, it is proven by simulation and test runs. It then runs within clear guardrails, with approvals at first, and Aitonomy keeps watching it.

Your team is needed mostly at the start, to explain the work, the people involved and the tools they use. After that, the team approves the design and the moment it goes live.

Three stacked layers. At the bottom, security and governance: access limited to what each step needs, and every action recorded in the EU. In the middle, the process design: six steps in three lanes, with 70 client rules. On top, the agentic design: reading and checking the hours is done by the agent, payroll and invoices are prepared by the agent and released by a person, tested on 8 past weeks.
Two designs. The process design comes from your team’s answers. The agentic design is made by Aitonomy on top of it, and proven before it runs. Security and governance sit under every step.

The process design: understand the process

Context · Strategy · How Context works →

It starts with the process as it runs today, and with your goal. The firm’s operations director explains the problem to Aito in a few sentences, by voice on her phone: approvals arrive too late, the office loses Wednesday to chasing them, and payroll on Thursday is under pressure. Success, for her, is approved hours on the day of the shift and an office that only handles the exceptions.

Aito then asks the right questions until the picture is complete, and passes questions on to the people who know the answer. Who takes part in the process, inside the firm and at the clients? Which tools are used at each step? Which rules apply, and how does the team actually work, including the exceptions? Where does the work wait?

The questions go to the people who do the work, in Teams, by mail or in the Aitonomy app, where they can simply answer by voice. Aitonomy also reads what the systems already show. Nobody has to write a process description or fill in a template.

From the answers, Aitonomy draws the process: every participant, every step, the tools, the rules and the way of working, with the hours and days each step takes today. That picture is the process design. The process owner checks it and confirms it, together with the goal and the business case.

Two screens. On a phone, the planner Daan is asked who approves a correction to the hours at Care site East, and answers by voice: the team lead, and above 250 euros payroll as well. Beside it, the process page for hours to pay and invoice: the goal, six steps in three lanes (professional, client, office) with the tool per step and chasing approvals marked as waiting two days, a baseline of 120 office hours a week, 1 in 4 timesheets corrected and 3 days from shift to approved hours, and a button to confirm the process design.
The process design. A planner answers a question by voice in the app; the process page fills in with the steps per role, the tools, and the baseline. The process owner confirms it. Example screens.

The agentic design: make it agentic

Agents, Security and governance · Delivery · How agents work →

With the process design confirmed, Aitonomy makes it agentic, automatically. It lays an agentic design on top of the process as it runs today, aimed at the goal.

For every step it sets who does the work: the agent on its own, the agent after a person approves, or a person. At Example Care Staffing, reading and checking timesheets is done by the agent. Payroll and invoices wait for a person to release them.

It chooses a suitable model for each step, hosted in the EU, and sets the guardrails: which systems each agent may read and change, and what it may never do without a person. It lists the systems to connect, such as the payroll system and the accounting package, and asks the right person to connect them.

The process owner reviews the agentic design and approves it. Nobody at the firm has to design anything.

The agentic design for hours to pay and invoice. Six steps: read the hours, get approval, check client rules and prepare payroll are done by the agent; release payroll is done by Sanne in payroll; invoice clients is done by the agent after approval. Each step shows an EU-hosted model and its tools. Guardrails: the agents read the app, the client portals and AFAS, change only draft payroll batches and draft invoices, and never pay, send an invoice or change a client's terms alone. A button to approve the design.
The agentic design. For each step: who does it, which model, which tools, and the guardrails. The process owner approves it. Example screen.

Prove it, then run it

Agents · Delivery · How agents work →

Before anything runs for real, the agentic design has to prove it does what it should. Aitonomy simulates it on the firm’s own past weeks and compares the agent’s results with what the back office actually did.

Then it does test runs on the real systems. It reads everything it would read and shows what it would do, without changing anything.

When the results meet the agreed quality, the process owner confirms and it goes live, within the guardrails set in the design. At first, the steps that change something run with an approval: a person sees what the agent proposes and approves it with one tap.

It runs on a schedule, every weekday at 08:00. The team approves in the channels they already use: Teams, mail or the firm’s own Aitonomy app on their phone. Aitonomy trains each role on the screens that role will use.

Two screens. The tests page: a simulation on 8 past weeks, 9,460 timesheets, 94 percent matching what the back office did against an agreed 90 percent; a test run on the real systems, 1,180 timesheets read and nothing changed; live every weekday at 08:00 since 2 November. Beside it, a phone with an approval card: release payroll for week 45, 1,184 timesheets for 598 people, three corrections listed, and buttons to reject or approve.
Proven, then live. A simulation on eight past weeks and a test run that changes nothing, then live with approvals first. Example screens.

Monitor quality, compliance and cost

Intelligence, Security and governance · Adoption · How Intelligence works →

Once the process runs, Aitonomy keeps watching it. Quality is checked against the criteria agreed at the start, and the owner gets an alert when results drift.

Every action and every approval is recorded. Each agent reaches only the systems its steps need, and the evidence is ready for an auditor or an inspection.

Usage, cost and time saved are visible for the process, including what the agents used in AI models. Anyone with access can ask, for example “what did the hours process cost last month, and what did it save?”, and get an answer with its sources.

The process keeps improving. Where the agent has proven itself, the owner can stop approving a step; the approval comes back as soon as the process changes. When a correction keeps coming back, the owner asks for a change, and Aitonomy designs and tests the new version before it runs. Every version is kept, and the earlier one can be restored.

Two screens. The results page for the process: 94 percent approved on the day against a goal above 90 percent, 99 percent checked before payroll, an estimated 380 office hours saved this month, and 370 euros running cost against a budget of 600 euros, with every action recorded. Beside it, a phone with an approval for four break corrections, noting the step was approved 12 weeks in a row without a change, with an option to approve and stop asking for this step; the approval comes back when the process changes.
Quality, compliance and cost in view. Results against the agreed goals, every action recorded, and an approval that can stop asking for a step that has proven itself. Example screens.

The result

BeforeAfter (example)
Shift to approved hoursAbout 3 daysSame day for most shifts
Office time per timesheetAbout 6 minutesAbout 1.5 minutes
Office hours on timesheets each weekAbout 120About 30
Timesheets that need a personAllAbout 1 in 10
Corrections found after payrollEvery weekRare, checked before Thursday

How we calculate it. 1,200 timesheets a week × 4.5 minutes saved is about 90 office hours a week. At €45 an hour that is about €4,000 a week, or about €200,000 a year, before the cost of the platform. Invoices also go out earlier, which shortens the gap between paying weekly wages and being paid by clients.

Put in your own numbers, and the conversation is about one process and one business case. How to build the business case →

BEFORE AND AFTER, EXAMPLE FIRM WITH 1,200 SHIFTS A WEEK Before After (example) Office hours on timesheets, per week 120 h 30 h Timesheets that need a person, per week 1,200 120 Days from shift to approved hours 3 days same day
Example figures. The inputs are under “How we calculate it”; for a customer, they are replaced by measured figures.

Within your rules

Security and governance · How Security and governance works →

Data. Hosted in the EU and never used to train a model.

Access. Each agent reaches only what its task needs, with rights taken from your own systems.

Approval. At the steps you choose. Payroll and invoices are released by your own people.

Record. Every action and approval is kept, ready for your auditor, the NEN 4400 inspection and the Wtta. How we handle security →

Where it can go next

Once the process runs agentically, it can move further towards an AI-native process. Steps merge, waiting time disappears, and approvals stay only where they matter.

The same context and the same team are ready for the next process.

ProcessWhat the agent does
Equal-value pay per clientCollects each client’s terms, applies them and keeps the evidence
Shift requests and sick callsFinds a replacement before the planner’s phone rings
Papers that expireWatches ID, BIG registration, diplomas and certificates of conduct, and keeps the file ready for inspection
End dates and extensionsFlags assignments before they run out

Start with one process. In a 30-minute use case session we map your hours-to-invoice process with you. You get a one-page process map, whether we continue or not. Book a use case session →

Start from the process you run today, and let it improve from there.

Sources

Next step

Start with the work
that slows your teams.

Bring us the work that slows your teams down. We will map it, count what it costs today, and select the first role only when the numbers support it.