diff --git a/lib/message-queue.js b/lib/message-queue.js
index 17c398b..b93f695 100644
--- a/lib/message-queue.js
+++ b/lib/message-queue.js
@@ -1,7 +1,5 @@
 const _ = require('lodash');
 
-// TODO... what indexes should be created and should this be responsible for creating them?
-
 function MessageQueue() {
   const self = this;
 
@@ -9,6 +7,8 @@ function MessageQueue() {
 
   self.databasePromise = null;
   self.collectionName = '_queue';
+  self.createIndex = true;
+  self.indexName = 'poll-index';
 
   self.pollingInterval = 1000;
   self.processingTimeout = 30 * 1000;
@@ -20,7 +20,7 @@ function MessageQueue() {
 
   self.registerWorker = function(type, promise) {
     _workers[type] = promise;
-    _startPolling();
+    return _startPolling();
   };
 
   self.stopPolling = function() {
@@ -80,13 +80,37 @@ function MessageQueue() {
 
   //region Private Helper Methods
 
-  function _startPolling() {
+  async function _startPolling() {
     if (!_pollingIntervalId) {
+      // Temporarily assigning polling interval to prevent multiple polls starting while index is being created
+      _pollingIntervalId = -1;
+
+      if (self.createIndex) {
+        await _createQueueIndex();
+      }
+
       // Try and find work at least once every pollingInterval
       _pollingIntervalId = setInterval(_poll, self.pollingInterval);
     }
   }
 
+  async function _createQueueIndex() {
+    const collection = await _getCollection();
+
+    await collection.createIndex(
+      {
+        type: 1,
+        rejectedTime: 1,
+        nextReceivableTime: 1,
+        receivedTime: 1
+      },
+      {
+        sparse: false,
+        name: self.indexName
+      }
+    );
+  }
+
   function _stopPolling() {
     if (_pollingIntervalId) {
       clearInterval(_pollingIntervalId);