Background: UPMC CancerCenter is a large outpatient medical oncology network of 25 locations, located within a 200 mile radius of Pittsburgh, PA. Covering all of these centers with a limited pool of float nurses was a daily challenge. The literature describes many attempts to quantify nursing workload retrospectively based upon complexity, hours of nursing time, etc. The ability to schedule staff equitability in advance is critical to managing staff. New targeted therapies and complicated treatment regimens which impact patient acuity bring to light the need for accurate acuity measurement. Methods: The first step in designing an acuity model was to determine the level of complexity of each treatment regimen based on standardized criteria. The model is a five point system encompassing route, teaching, reaction potential, etc. designed by frontline nurses. A designated nurse at each site calculates the acuity and enters it into an online system prospectively. Nursing Administration can view the staffing and acuity rating across the entire network. This enables the assignment of float nurses to the location with the greatest need. Results: A stoplight report using the database was developed to highlight the sites that are outside of 0.5 standard deviation (SD) range for both the acuity and patient ratios. It was determined that the average nurse to acuity ratio was 11.92 (within SD range 10.69-13.16). The average nurse to patient ratio was 6.31 (within SD range 5.6-7.03). This enables Nursing Administration to identify sites that typically operate below or above the average range in order to better allocate nursing resources. This report is shared among all sites to provide transparency which has improved understanding by the staff of nursing resource allocation. Conclusions: The development of this prospective acuity system has helped to quantify treatment complexity to better allocate daily staffing resources. Further evaluation is necessary to determine the optimal ratios that are the most economical while still providing safe patient care. There are future plans to link the acuity levels to treatment regimens within the Electronic Medical Record to reduce the manual workload.