Call Monitoring Form

CCV – Cancer Helpline  Call Evaluation Tool

Operator Details
Name:                                                                              Date:
Caller Type:
Name: ______________________________ Age: __________________Postcode: _______________How found: ______________________________________Reason for calling: _______________________________

 

 

Comments
Supervisor’s Comments:                                                                                 Total Score: __________Recommended Actions/Coaching to be Undertaken:

 

 

 
Cancer Nurse’s Comments:
I fully understand the ‘Recommended Actions’ described within this document and the ‘Coaching to be Undertaken’ items listed that are to be achieved by the next review date _____ / _____ / _____.Cancer Nurse’s Signature:  ____________________________________ Date:  ____ / ____ / ____Supervisor’s Signature:  __________________________________         Date:  ____ / ____ / ____  

 

Adapted from information and experience shared by John-Paul Kristensen.

 

 Section One: Communication SkillsObjective:  The Cancer Nurse (CN) communicates effectively with the caller. 
Competencies (All Calls) Score Comments
CN builds rapport with caller (use of name etc) (2)Appropriate language used for caller (2)CN’s voice, pacing and tone is used appropriate (2)CN’s speech is clear (2)CN listens to and clearly identify caller needs (2)
 TOTAL SCORE       / 10

 

 

Section Two: Emotional SupportObjective:  The Cancer Nurse (CN) demonstrates appropriate techniques
Competencies (All Calls) Score Comments
CN displays empathy and understanding (2)Use of basic skills (reflecting feelings & content, paraphrasing, summarising, open questions) (2)Use of medium skills (reframing, exploration of feelings and options) (2)
TOTAL SCORE      / 6

 

Score:     0 = Expectation Not Met         1 = Needs Improvement           2 = Expectation Met / Not Applicable

Section Three: Services & InformationObjective:  The Cancer Nurse (CN) competently assesses need for support/information
Full range of support options/services discussed, including CC, CSG, internet/telephone support call back) (2)Service providers supplied were appropriate for the caller’s needs. (2)Full range of literature discussed. (2)Literature provided is appropriate for the caller’s needs. (2)Provides information on the hours of the Helpline. (2)

 
 TOTAL SCORE       /10
Section Four: Collection of Data & OnCall Call EntryObjective:  The Cancer Nurse competently collects and records caller/client information
Competencies (All Calls) Score Comments
Collected the essential information for documentation. (2)Records accurately, including mandatory fields (how found, postcode, age, gap in service) on Salesforce database (2)Follows CISS policies and procedures during the course of the call (confidentiality etc) (2)

Score:     0 = Expectation Not Met         1 = Needs Improvement           2 = Expectation Met / Not Applicable

Score
 Section One:
Section Two:
Section Three:
Section Four:
TOTAL SCORE:

 

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