At Oregon Oncology Specialists, our patients are always at the center of everything we do. “Patient first, not process” is a phrase that guides our work every day. But as our clinic grew busier and more complex, our old process for assigning patients to nurses started to make it harder to live that mission.
The Challenge: Manual Assignments, Long Days, and Constant Stress
Before implementing the Nurse Pull in iQueue for Infusion Centers, our daily assignment process relied on pre-assigned patient schedules. Every afternoon, our lead nurse spent hours building the next day’s assignments – balancing patient acuity, appointment lengths, and staff capacity – attempting to evenly distribute the workload. Despite that effort, the reality of oncology care meant that no-shows, add-ons, and changing patient needs often disrupted the plan.
Our nurses would spend time the night before prepping for their patients, only to arrive the next morning and find that sick calls, late arrivals, or cancellations had completely reshuffled the day. That constant change created bottlenecks and inefficiencies. Some nurses were overwhelmed while others waited for patients who never came. Add-ons were a particular challenge, creating stress for charge nurses and frustration for staff.
The pre-assignment approach made it difficult to consistently balance workload and maintain breaks. It became clear that to better support both our staff and patients, we needed a new way to manage patient assignments in real time.
The Turning Point: Trusting Data and Taking the Leap
We’d been using iQueue for some time, but when LeanTaaS introduced the “Nurse Pull” model of patient assignment, we saw an opportunity to rethink how our infusion floor operated. Initially, we were hesitant. Our nurses valued having their schedules ahead of time, and we worried about losing the time to prepare for patients in advance of their arrival to the clinic.
But with guidance from the LeanTaaS team, we began to see how data and real-time visibility could empower – not replace – our nursing judgment. The team walked us through the metrics, modeled our potential gains, and helped us visualize how this new process could work for us. They also connected us with similar infusion centers implementing Nurse Pull who were willing to share their experience and answer questions. Eventually, our team decided: if it could make patient care better and reduce daily chaos, it was worth a try.
We committed to a one-month trial. “If we don’t like it, we can always go back,” we told our nurses. But we never did.
The Solution: A Smarter, Fairer Way to Assign Patients
With Nurse Pull, our nurses assign themselves to patients as they arrive, using the live iQueue dashboard to see who’s next. This approach gave us the structure and flexibility we were missing before.
Instead of spending hours building schedules that would inevitably change, nurses now start their day ready to adapt in real time. They have the autonomy to choose which patient to take next, factoring in their skill set, comfort level, and workload. Newer nurses can choose less complex regimens, while seasoned nurses can take on higher-acuity treatments.
The competition at first was friendly but fierce. Some nurses joked that it felt like “The Hunger Games” as they raced to pull patients. Over time, the process found its balance. Teams communicate openly, using chat tools and visual cues in iQueue to coordinate. Our charge nurses now have visibility into workloads, ensuring assignments stay fair and that everyone gets their breaks.
The Impact: Less Chaos, More Care
The results were immediate. Within weeks, the stress level on our infusion floor dropped. Schedules flowed more smoothly throughout the day, bottlenecks disappeared, and everyone, nurses and patients alike, felt the difference.
Our nurses now consistently get their lunches and breaks, something we once thought impossible. They’re able to spend the appropriate amount of time with each patient, focusing fully on care rather than juggling overlapping appointments or worrying about who’s coming next. Same-day add-ons have also become much easier to manage. Instead of requiring a charge nurse to intervene or negotiate to fit an extra patient in, those patients are simply added into the queue. Whoever is available at the time takes the next patient, often without even realizing that person wasn’t originally on the schedule.
Patients notice the difference, too. The environment feels calmer and more predictable. Check-in to chair time is faster, and treatments start with less waiting. They often comment on how smoothly things run and how present their nurses feel.
Operationally, we’ve gained new insights and efficiencies. iQueue’s data now helps us plan staffing levels, track add-ons, and identify trends. We can visualize peaks and valleys across the week, anticipate busy days, and even use the data to justify staffing adjustments. Additionally, we’ve been able to increase our appointment templates, expanding availability and offering more appointments to our patients without adding staff. This improvement demonstrates how Nurse Pull not only creates efficiency but also supports growth and access.
Since implementing Nurse Pull, our case volume has also increased by roughly 5% year over year, even though staffing levels have stayed largely the same. While we can’t attribute that growth solely to Nurse Pull, it’s an encouraging indicator that the new process may be contributing to greater efficiency and capacity.
Our scheduling team is beginning to integrate with iQueue as well, which will bring even greater coordination between scheduling and clinical operations.
The Partnership: Collaborative Support Driving Success
One of the biggest contributors to our success has been our partnership with the LeanTaaS team. From the beginning, the support team was deeply invested in helping us succeed. They visited our site, met with staff across departments, and made sure every part of the process fit our environment. Their responsiveness and commitment have been unmatched, and we often say, “Why can’t every vendor be like LeanTaaS?”
The Takeaway: Empowering Nurses to Lead Change
For other infusion centers considering Nurse Pull, our advice is simple: do it. It may feel daunting to give up the old way of assigning patients, but the payoff is worth it. You’ll gain time, clarity, and a more satisfied nursing team.
For us at Oregon Oncology, this change has been transformative. We’ve optimized our workflows, strengthened collaboration, and most importantly, made it easier for our nurses to do what they do best: take care of people.
