Designing “Air Traffic Control” for Charge Nurses
How I turned real-time staffing chaos into a daily-use tool with 41% engagement
PROJECT SNAPSHOT
Business impact
41.5%
DAU/MAU
59.5%
customer adoption (hospitals)
31.7%
user adoption (nurses)
Customer impact
+10%
nurse productivity improvement
80%
nurses satisfied with their assignments
90%
nurses are better able to take breaks
Customer feedback
"Patient Assignment was a godsend. It was a challenge for the iQueue team to convince me, I must have said 'no' a hundred times. My nurses also said 'absolutely not, we'll quit if we do this'. I convinced the nurses to trial it for 5 days and the feedback came back an overwhelming success. It's one of the best decisions I've ever made."
Nurse Manager at Lee Health Regional Cancer Center
"All I can say is WOW! We can truly see what a dramatic impact this has on our patient flow and the nursing workload throughout the day. We very quickly identified that this way of doing Patient Assignment is FANTASTIC!!!"
Nurse Manager at Vanderbilt-Ingram Cancer Center
"We gave nurses the choice between using their spreadsheets and Patient Assignment, and they chose to continue using PA because they liked it so much. They haven’t used their spreadsheets in 2 weeks!"
Nurse Manager at MD Anderson Cancer Center
Outcomes
Key retention driver
Competitor replicated the feature
Churning customers asked to keep this feature and turn off the others
Scope
0→1 real-time staffing tool
Served previously underserved 60% segment
My Role
Sole designer → Acting PM
Discovery to delivery
Cross-functional leadership
Timeline
Concept to launch: ~8 months
In infusion centers, patient assignment isn't just scheduling. It determines:
Nurse workload
Patient wait times
Staff satisfaction
Operational efficiency
KEY TAKEAWAY
Yet most charge nurses were managing assignments like air traffic controllers — juggling spreadsheets, whiteboards, and memory.
Meanwhile at
60% of customers were underserved
Churn risk was rising
A previous staffing tool had failed
Competitors were catching up
The initial framing: Increase engagement
Leadership’s goal was simple:
“Make charge nurses log in daily.”
But usage is an outcome — not a goal
We had already tried forcing a workflow once. It failed. Nurses resisted rigid systems.
I pushed to ask a better question:
"Why do assignments feel so hard in the first place?"
Our previous tool focused on one patient assignment method - pulling - but forcing nurses into a rigid system failed as they sometimes needed to push or pre-assign certain patients.
Failed product's designs
KEY TAKEAWAY
Leadership asked for higher daily logins. I focused on reducing decision chaos. That shift turned this into one of our most adopted and defensible features.
Reframe From usage to decision support
Shadowing charge nurses revealed that assignments weren't just logistical. They were mental and emotional. Charge nurses constantly calculate:
Treatment duration
Nurse workload
Fairness
Patient readiness
Schedule gaps
Fairness wasn’t a nice-to-have. It was central to team morale. The real problem wasn’t assignment. It was managing uncertainty.
How might we encourage the underserved 60% of customers to use the app daily?
How might we help charge nurses gain visibility into their nurses' workload and identify who is ready to take the next patient, while ensuring balanced assignments?
KEY TAKEAWAY
If we reduced cognitive load, daily usage would follow. That reframe guided the product.
The moment I knew it would work
I tested multiple prototypes, but nurses couldn’t fully imagine the value of a real-time tool. The hesitation wasn’t rejection — it was uncertainty.
Rather than rely on opinions, I proposed building a quick, low-effort proof of concept using real customer data to validate real-world usefulness.
Repurpose an unused page from the failed project
Re-connect real customer data
Build a quick proof-of-concept
During the POC testing, a charge nurse noticed a red timer: 1h 40min since last patient.
She assumed our data was wrong. She checked the EHR. It was correct. Without saying anything, she left.
Suddenly, I saw the timer reset. She didn’t need to say the tool worked…
Her behavior proved it. That moment changed the project’s trajectory.
KEY TAKEAWAY
When designing real-time tools, behavior is more reliable than verbal feedback. Seeing the tool in action revealed value that prototypes couldn’t.
The tension: Flexibility vs control
Here’s where real trade-offs appeared:
From the start, I intentionally designed for flexibility
We had already seen a rigid workflow fail, and I wanted this tool to support how nurses actually work — not force a new process onto them.
Stakeholders wanted to protect operational efficiency and ensure ROI
I agreed with the goal — but not the method. Sustainable behavior change comes from adoption, not enforcement.
They proposed adding friction or limiting workflows to steer behavior
While well-intentioned, this risked reducing adoption and repeating past mistakes.
I advocated for meeting nurses where they are. Forcing behavior change had already failed once. I chose:
Flexibility first
I designed the system to support multiple assignment styles — pre-assigning, real-time push, or nurse-driven pull — so teams could adopt the tool without changing their workflow overnight.
Pre-assign
Real-time push
Nurse-driven pull
Optimization later
Instead of enforcing efficiency upfront, I designed Staff Performance metrics to surface productivity, workload balance, and assignment patterns over time.
Monitoring instead of restriction
Rather than limiting behavior, we agreed to monitor outcomes. If flexibility reduced performance, we could introduce guardrails later. In practice, adoption and performance improved — restrictions weren't needed.
KEY TAKEAWAY
I prioritized adoption over theoretical operational efficiency. It worked.
Key product decisions
Design for flexibility, not restriction
I surfaced readiness and workload signals helping charge nurses make decisions better while still being in the driver's seat.
Reduce cognitive load
I simplified information until decisions felt effortless. These decisions drove adoption more than feature complexity.
Validate with behavior, not opinions
The POC prevented blind investment.
Previously failed product was repurposed for creating a quick POC for testing.
Quick & low-effort POC showing real-time customer data to test the value.
KEY TAKEAWAY
Context reduced tension more effectively than stricter prioritization rules.
When the PM went on leave, I took the ownership
Right before development, our PM went on leave and a replacement lacked context. To keep momentum:
I prioritized backlog
Sequenced work
Clarified implementation
Aligned engineers
This is an example of how I kept track of the work, priorities and implementation.
Organizational impact
This project shifted how we build products.
My discovery framework became a company staple, shared across teams.
Process driven
Rigid workflows
“We know better”
Research-driven
Listening to reality
Flexible systems
What this project says about my approach
I design for real environments where:
Constraints are real
Human factors matter
Adoption beats perfection
I don't just ship features. I help teams make better decisions about what not to build — that judgment matters as much as the design itself.
I reframe before solving
I validate behavior, not just opinions
I design within domain boundaries
I balance autonomy with accountability
Reflection
This project reinforced that:
Visibility reduces stress
Fairness drives adoption
Flexibility builds trust
Behavior is the best validation
KEY TAKEAWAY
Staffing tools aren’t just operational. They’re emotional systems.