Introduction Management of the various aspects of critically ill patients requires precision and attention to detail. The ICU Census (``Census’’) is a custom database system for the management of logistical, clinical, and reporting mechanisms as they relate to patient care in a specialized oncologic medical-surgical ICU. We report the design and implementation of the Census. Design The Census is a MS SQL backend with an ASP.NET frontend, with various .NET windows service connections to a multitude of interfaces. ICU admissions, consults, rapid responses, inter-hospital ICU transfers are tracked and recorded through the standardized forms that can then be viewed in aggregate through the ICU Greaseboard located on screens throughout the ICU and any computer logged into the secured network. The data that is collected during a patient’s ICU stay ranges from procedures or interventions to novel clinical trial therapeutics for a patient’s cancer care. These items are retrospectively reviewed for research on critically ill cancer patients. Reporting Each morning, an aggregated rounding report for each ICU team is automatically produced as a PDF document and sent to the ICU team. This report organizes the lab, medication, and procedural data by organ systems for each patient. There are multiple ICU, respiratory therapy, and pharmacy workflows that utilize the Census to aggregate data in Tableau Dashboards. Additional ICU reports for mortality, admission and discharge data, demographic data, and procedures can be easily produced. Conclusion The management of patient flow coordination and critically ill patients can be effectively managed through the ICU Census. The automation of the manual inputs is underway and we plan to release the design as open source for other ICUs that are interested in the design.