A cardiac care information service can run a very busy phone line and still have no idea whether its staff are improving. Volume is easy to measure; skill is not. This audit offers a way to tell the difference. It is a twelve-point checklist that a desk lead can finish in one sitting, drawing on only a sample of the desk’s own enquiry notes and a few practice sessions. It deals only with administrative competence: call handling, form checking and passing questions to the right people. It does not touch clinical judgement, and nothing here is medical advice.
The premise: repetition is not the same as improvement
The thinking behind the checklist is simple, and it is supported by a long line of research on how people acquire skills in many fields, from music to sport. Time spent repeating a task without targeting a weakness tends to stabilise performance at a comfortable plateau. Gains come from short, concentrated attempts at the specific element that is failing, followed by prompt and honest feedback and a small change to try next. In this article that approach is called deliberate practice, and the audit asks twelve questions to find out whether your desk is doing it or merely doing its hours.
How to use the audit: for each item, score yourself yes, partly or no, and write one line of observation. Do not aim for twelve yeses. A desk that scores itself honestly at seven or eight and picks two items to improve is doing better than one that scores itself perfect and changes nothing.
Part A: Choosing the target (items 1 to 4)
- Is there a named weakness for each person this month? Not “improve communication”, but something like “confirm a return number on every call”. If nobody can name theirs, the practice is unfocused.
- Was the weakness chosen from the desk’s own notes? Sample ten recent enquiry records. Count how often the sender had to repeat information, or a colleague had to ask a clarifying question. The most frequent gap is a better target than anyone’s hunch.
- Is the target a behaviour, not a feeling? “Sound more confident” cannot be observed. “Pause for one breath before giving a date” can.
- Is there one target at a time? If a person’s list has four items, count it as zero; they will improve at none of them.
Part B: The drill itself (items 5 to 8)
- Does a drill last under fifteen minutes? Longer sessions drift. Short ones stay sharp, and they are easier to schedule, which matters more than any theory.
- Is the scenario written down and varied? A drill that always uses the same scripted caller trains the script. Check that at least three different scenarios have been used in the past month.
- Does someone other than the learner observe? Self-assessment tends to flatter. A colleague, a supervisor or a recording made from invented scenarios adds the missing view.
- Is there a second attempt in the same session? The adjustment is only real once it has been tried. A drill that ends with advice and no retry has skipped the useful half.
Part C: Feedback and follow-through (items 9 to 12)
- Is feedback specific and limited to one observation? Review a few sessions. “That was good” is a warning sign. “You gave the day but not the time” is what you want.
- Can the person say what they changed? Ask them. If the answer is vague, the feedback did not land.
- Is there a check a week later? Run the same scenario without feedback and see whether the change persisted. Retention is the actual measure of learning, not performance in the session itself.
- Are targets retired and replaced? A target that has been the same for three months suggests either no progress or a drill that has become ritual.
Reading the results
Count your yeses in each part. Scores tend to cluster in a recognisable way, and the pattern tells you where to act.
- Strong A, weak B. People know what to work on but practise in a way that wastes the knowledge. Shorten sessions and add an observer.
- Weak A, strong B. Drills are well run but aimed at guesses. Go back to the notes and find the real gap.
- Weak C. This is the commonest pattern. Sessions happen and feel useful, but nothing is checked afterwards. Add item 11 first; it costs five minutes and is the cheapest evidence you will ever collect.
Resist the temptation to turn these scores into a league table. The audit is a conversation starter for the desk, not a performance rating for individuals, and it works only if people feel safe to say “partly”.
A note on terminology that staff meet
Enquiry staff at a cardiac service often hear clinical vocabulary from callers and referrers, and part of good desk practice is knowing which words to pass on rather than interpret. General reference reading helps with recognition, though not with judgement. One overview on the NYHA functional classification as cardiologists use it while a second explainer covers the way murmur grades are written up are examples of terms a desk may meet. They are informational reading only; staff should never apply them to a caller’s own situation, and questions about health go to a clinician.
When the audit points to a skills gap in the technical team
Occasionally the audit shows a weakness that sits behind the desk, in the systems staff use to log and route enquiries. If the team that maintains those systems wants outside coaching on a single focused skill, they could start by browsing the DevOpsTrainer directory, where coaches and instructors for DevOps and related disciplines are listed by skill route. The front desk checklist above needs no outside help at all.
A worked scoring example
Suppose a six-person desk runs the audit. Item 2 scores a clear no: nobody has looked at the notes in months. Item 5 scores yes, because the team already holds ten-minute huddles. Item 8 scores partly, since drills end with a tip but rarely a retry. The lead picks two actions. First, sample ten notes and count repeated information; the count shows that return numbers are missing in four of ten. Second, change the huddle format so each person does one retry before sitting down.
Four weeks later the lead repeats the sample and finds the return number missing in one of ten. The sample is small and nobody should call it proof, but the direction is clear and the cost was a few minutes a day. That is the kind of modest, checkable evidence the audit is designed to produce.
What to collect as you go
- A one-line target for each person, dated.
- The scenario used in each drill, so you can see variety at a glance.
- The single observation the listener gave.
- The adjustment the learner tried, and whether it held a week later.
Four short lines per session is enough. Anything longer will be abandoned by the second week.
Running the audit: a practical schedule
- Block ninety minutes. Pull ten enquiry notes and one week of practice session records, if any exist.
- Score the twelve items alone first, then compare with one other person.
- Choose the two lowest items that you can change this month.
- For each, write the single next action and who will do it.
- Repeat the audit in a quarter and compare, noting which scores moved and why.
Keep the sheets. A year of quarterly audits gives you something rare in a service role: a record of actual skill development, not hours worked.
What the numbers will not tell you
An honest limitation: this checklist measures process, not outcomes. A desk can score well on all twelve and still have a hard month because of staffing or system problems. It cannot say whether callers feel better looked after, either; for that you need their words, collected in whatever way your organisation already permits. Treat the audit as one lens, not the whole picture.
Even so, it asks a question that rarely gets asked: are we getting better, or are we just getting through the day? Twelve boxes, one afternoon, and a plan for the next quarter will give you a more reliable answer than any amount of gut feel.
