CEO's address

The past year has been eventful, stressful and fun at the same time.

The Covid epidemic and response to it framed the year; at the very end of 2020, vaccinations began among residents of nursing homes, and by the end of the year, the omicron variant had not yet caught up, so to speak.

Among other projects that have left their mark on the year are the shortening of the working week in daytime and shift work, the implementation of regulations related to the European Union's personal data protection legislation (GDPR) and a new look and feel at the end of the year.

As in life itself, daily work has moved somewhat into the electronic world, and Workplace has been our home ground for internal communication, welcome when all coffee hours are canceled, annual celebrations and fun.

Last year is the first full year in which work is being carried out according to the 2020–23 strategy and therefore material to settle the year with regard to the performance indicators that were set. Many of them are green and many goals have been achieved. Others have not been achieved, and a settlement of this kind is therefore a useful reminder not to forget the course but to continue even if everything does not go as planned.

As I write this, the results of the survey about Organization of the year which measure job satisfaction in various ways. They show that our rating is still rising. It has never been higher and is higher than at our sister institutions. This is important; with good and happy staff, we all feel better, but the service also improves because with increased job satisfaction, we keep staff longer and we receive more applications for vacancies.

Gylfi Ólafsson CEO

Some numbers

1200

CT scans

1447

X-rays

224

Covid infection in the district. There were 114 in 2020 and 1,797 in the first 10 weeks of 2022

43

trips between Ísafjörður and Patreksfjörður
Northern regionSouthern region
Coming to the family doctor91552731
Comes to nurse28861593
Air ambulance5032
Admissions to the ward55150
Gastroscopies58
Colonoscopies95
Births (women who were in maternity care at the institution but gave birth to their children in other institutions)32 + (24)(20)
Some figures from 2021 activities

Strategy and performance indicators

Policy for the years 2020–23 was approved in late 2020. It set out key actions and numerical performance indicators.

Now at the beginning of the year 2022 there is an occasion to settle 2021 as the first full year under the new policy.

Detailed performance indicators were 25. Ten objectives were fully achieved. Four goals were partially achieved or it remains to be seen how this was achieved. Eleven goals were not achieved.

The calculation of the performance indicators is a mixed bag. Many of the green dots have required a lot of work and we can be proud of them. Other points are red. There are some things that we cannot fully handle, but other things that could have been done better. A number of quality projects have been on the back burner due to disruption and workload due to the pandemic. A settlement of this kind is nevertheless a necessary reminder of what has gone well, a review of the goals we have set for ourselves, and a useful tool for prioritizing limited time and funds.

Gylfi Ólafsson CEO

Nursing home

The Vestfjörður Health Institute operates four nursing homes:

  • Eyri on Ísafjörður, 30 spaces.
  • Nursing department at Patreksfjörður, 11 rooms.
  • Berg in Bolungarvík, 10 or 11 rooms.
  • Pond in Þingeyri, 6 or 7 spaces.

In total, these are 57–59 spaces, depending on how the double rooms are arranged.

The waiting time for a space is acceptable in the three smaller departments, but has been significantly longer in Eyri.

Three pictures about developments in Eyri

Eyri opened in 2016 with 30 spaces and it was already clear that there was a need for more.

Work is underway to prepare the fourth 10-room unit next to the home in cooperation between Ísafjörður town and the government.

The number of waiting days for people admitted to Eyri has been long since 2018 and significantly longer than elsewhere in the country.
In general, they have priority in nursing homes that have the most points according to assessment of the Skills and Health Assessment Committee. However, the rules assume that patients who have spent 6 weeks or more in the hospital, have completed treatment and are not returning home have priority in a nursing home, regardless of the number of points. In 2018 and 2020, a large part of those who were admitted to Eyri came directly from the hospital.
The skills and health assessment committee assesses the need for nursing space based on a questionnaire. The higher the need, the higher the score the applicants will get. The higher average score of those who get a place shows that people on the waiting list are worse off than before.
Home care increased a lot and in the middle of 2021 it was no longer enough. The situation has changed a lot for the better since this picture was taken.

In July, the decision was made to open duplexes in Ísafjörður and in Bolungarvík to shorten the waiting list. The waiting list for a nursing home had grown considerably during the covid situation. There is a very high need for those on the waiting list for the service and home care was no longer sufficient.

Other service recipients and relatives showed great understanding of this decision and this arrangement worked very well. The attached picture shows the development of the number of visits in home care, which describes the situation well.

Since then, the waiting list for space has shortened and the task of home nursing has become more manageable. The spaces are no longer shared, and hopefully we won't have to resort to that in the near future before a new 10-space unit opens on Ísafjörður as planned.

Poor medical staffing

The biggest single problem at the institute in the last year has been the poor staffing of doctors in primary care and the medical department.

In a service survey that was carried out at the initiative of Sjúkratrygging Íslands, the results for clients in the health care of the Vestfjörður Health Institute can be seen. Here on the right are two pictures of GÓ's lecture the forum of the association of senior citizens in Ísafjörður and its surroundings, which was held on October 7, 2021.

If we let two photos suffice, the first one shows that the vast majority of our clients believe that their business was well resolved when they arrived. There is still reason to try to reduce the percentage who believe that their mission was not solved successfully.

The second picture shows what people think needs to be improved. Shortening the wait for an appointment or service ranks first, followed by easier access to a doctor by phone, and third is registering a regular family doctor. In fourth place, there is a reference to increased electronic services, which can be interpreted in various ways, but for example, it has proven difficult to activate electronic appointment booking with primary care doctors due to the small number of them.

At the end of 2021, there was one permanent surgeon, Andri Konráðsson, one permanent primary care physician, Súsanna Ástvaldsdóttir, and one specialist in family medicine, Kristrún Guðmundsdóttir. They are intended to take care of the surgery and accident department, the hospital department and health care in the northern region, in addition to all the on-call duties. What is missing is solved with contractors, candidates and substitute doctors for longer and shorter periods. At Patreksfjörður, there are contractors who take turns working week after week, but most weeks are taken by Jón BG Jónsson, who has worked at the organization for a long time.

It is a priority to improve medical staffing with permanent doctors so that there will be continuity in services, the workload will be acceptable and stability will be achieved in the operation.

It has not been possible to fill the permanent position of a psychologist.

Was your case resolved well or badly when you entered the clinic? The vast majority said that their mission had been successfully resolved.
Which of the following do you think is most urgent to improve health care in general? The vast majority of answers were in one way or another about the lack of doctors.

Ambulances and air ambulances

Ísafjarðarbær operates ambulances in the district of Djúpi and west of Arnarfjörður according to an agreement with the health institute.

In the southern region, ambulances are run by the organization directly.

After a slump in 2020, the number of ambulances increased significantly in both regions. The increase was mainly in F2–F4 but less in F1, which are calls with the highest priority.

There were 50 medical flights from Ísafjörður and 32 from Bíldudal airport.

Rehabilitation

The organization runs a rehabilitation department in Ísafjörður. Here on the right are some figures from the department's activities. The department's operations were subject to various deficiencies due to covid, and therefore fewer visits than otherwise would have been the case. The years before covid were 11,000 to 13,000 arrivals per year.

In Bolungarvík and Patreksfjörður, there are self-employed physical therapists who are employed by the institution to train clients in the nursing wards.

Number of clientsMany comeExplanation
Hall, swimming pool1322146Those who come to practice in the swimming pool or hall. Preferably after graduation from physical therapy.
physiotherapy1832678Outpatients who come for physical therapy on request.
Work in a department67910Training of those who are in the hospital
Training at Eyri431787Training of residents in Eyri
Occupational therapy1181391Occupational therapy for both outpatients, residents of Eyri and inpatients. Also assistive device applications.
total3508912

Financial statements

As before, the organization's operation is a great challenge, but ways are constantly being sought to achieve efficiency in operations through increased restraint, increased cost awareness and technological innovations. The result for the year 2021 was negative by 61.5 million ISK or 1.9% of income. Fees increased between years by ISK 240.9 million or 7.8%. At the same time, income increased considerably less or by 104.9 million ISK or 3.3%.

The weight of labor costs was 73%, which increased by ISK 172.7 million or 7.7%. The pandemic continued to take its toll. We can also mention increases due to institutional agreements and the shortening of the working week, which called for increased staffing. The average number of full-time positions increased by 20.3 full-time positions between years, or by 11.8%. The weight of other operating expenses was 26%, which increased by ISK 61.8 million or 7.7%. The increase can be attributed primarily to an increase in the purchase of specialized goods, driving and specialist services. Depreciation increased by 6.4 million ISK or 32.7%, but the year's investments amounted to 68 million ISK. The weight of budgets was 92.4% and increased from the previous year by 59.2 million ISK or 2.0%. The weight of sold services was 6.0% and increased by ISK 36.0 million or 22.6% between years. The increase can be attributed to specialist services, accommodation fees and various service income. –HUH

The health district

Vestfjörður's health district is the least populated district in the country and includes five municipalities. The district does not follow the same district boundaries as, for example, an electoral district or a police district. All nursing facilities in the district are operated by the health institution.

Village corePopulation 1 Jan 2021
Patreksfjörður721
Talknafjordur248
Bildudalur238
Þingeyri292
Flateyri199
Suðureyri266
Bolungarvík934
Knife Valley203
Ísafjörður2.672
Súðavík160
Small farm in Vestfjörður687
total6.620

A short news report

The year was characterized by covid and the biggest part of the news during the year was covid-related the red thread in almost all news this year.

In mid-January, a decision was made to place the hospital in Ísafjörður at risk level, as a patient who was diagnosed with the corona virus at Landspítalan previously received services at the Vestfjörður Health Institute. Three workers were sent to quarantine and another three to processing quarantine. However, this dangerous situation did not last longer than almost a day, as all those who took samples turned out to be negative. It later turned out that the patient's sample had probably been a false positive.

Second vaccination for Covid-19. Vestfjörður Health Institute, Ísafjörður.

In April, it was time for vaccinations due to covid and senior citizens and health workers were vaccinated in large groups and busy when hundreds were vaccinated daily at the peak. Vaccinations continued well into the summer and, as elsewhere, only a break was made at the end of July to enable staff to take a short summer vacation.

Samples due to covid were in the foreground in August because then it was considered newsworthy that samples were transported south by taxi. Ever since sampling due to covid started, the samples were sent south by air, but as everyone who lives here knows, it happens that air transport is canceled. In those cases, staff have advertised both on the organization's Workplace page and on the Samferda page of the facebook page after the samples. This is how the samples have been sent, and with the help of the community and occasional taxis, the samples have always made it south.

In August, there was even more covid news because then one employee of the organization in the southern area was diagnosed with the infection, and two colleagues and eight clients went into quarantine. The infections were so rare then that the news found its way onto the pages of the media. At the end of August, large groups of elementary school students were sampled and about eighty people were sent to quarantine.

From the director's photo album

Of the news not related to covid during the year, the most notable was that the staff of the organization have used the Dýrafjörður tunnel to greatly improve the organization's services on Patreksfjörður with weekly trips between Ísafjörður and Patreksfjörður. Ideally, it should be mentioned the increased services of midwives in maternity care, psychiatric services and research, but staff transport various types of samples between Patreksfjörður and Ísafjörður during these trips. With the introduction of the tunnels, the staff of the organization believe that the process of uniting Patreksfjörður and Ísafjörður, which began seven years ago, is therefore complete.

Sigurveig accepts a candle modeled after the appearance of the old hospital where she started working.
Rehabilitation department staff. Next to Sigurveigar in a dark blue shirt is Sigríður Lára Gunnlaugsdóttir, who took over the position of head of the rehabilitation department.

Veiga retired after more than 40 years of work

In mid-August, Sigurveig Gunnarsdóttir, head of the rehabilitation department, resigned after working at the institution since 1980.

In Ísafjörður, rehabilitation services or physical therapy were not available until physiotherapist Sigurveig Gunnarsdóttir started working in October 1980. Veiga had graduated two years earlier in Årós. For the first few years, she had facilities in the attic of the old hospital, which would have been nice if the clients could now climb the stairs in the elevator-less building! For a long time, she was alone at work, except for replacements. She took care of everything, both in-patient and outpatient services.

In 1985, the department moved to the basement of a new hospital. Due to the narrow space in the old location, the completion of the rehabilitation was accelerated beyond what had been previously planned. When it opened, the facility was one of the best rehabilitation units in the country with a large equipment room and a swimming pool suitable for various types of swimming and infant swimming.

Here in the house she has been like that every day. Except for that one sick day she had to take her entire career.

Veiga has been extremely successful at work. She is positive and cheerful, and apart from her nimble but strong fingers and hands, she has exceptionally good ears. As a result, the rehabilitation department has retained exceptionally good staff and clients speak volumes about the quality of the service. –GO

During the summer, the decision was made to open duplexes in Ísafjörður and in Bolungarvík to shorten the waiting list. The waiting list for a nursing home had gotten quite long in the covid situation and there was a very high need for those on the waiting list for the service. Other service recipients and relatives showed great understanding of this decision and this arrangement worked very well.

Finally, it was in the news about the institution that winter arrived with a bang at the end of September, but a big storm passed with the result that the ceiling panels in the basement came off and the roofing felt fell off the roof of the main building of the hospital. However, there were no accidents. Industrialists responded quickly and there was no disruption to operations.

Throughout 2021, the organization encouraged people with various announcements and messages to take care of quarantine, to take samples and to attend vaccinations. In the second half of the year until Christmas, there were many people in the rapid test due to the long-awaited events and gatherings, which could then be attended with confirmation of a negative rapid test. Hopefully there will be less covid news in 2022 and hopefully "it will be over" in that year.

Additional news from our site is: Housing improvements, dentist who came and went, Kisur and a new look.

Directors

The executive board makes all major decisions regarding the organization's operations. It has remained unchanged throughout 2021.

There are 16 department heads.

Susanna Ástvaldsdóttir has been the chief doctor of health care in the northern region and the district doctor of epidemic prevention. Susanna has been involved in that role ever since the outbreak began in March 2020. Infection tracking and decisions about quarantine measures within the district and the organization have largely been hers. There have been many difficult decisions. Among other things, bad weather, immobility and the nature of society in the Westfjords have had a great influence on those decisions. Thus, there has often been a long wait between sampling and the result being obtained. In such cases, decisions have to be made under great uncertainty.

Along with this, Súsanna holds the position of chief physician at health care, whose role it is to ensure staffing there, and performs reception and shifts at health care and in the emergency department. She is also active in taking care of the medical students who work at the institution for a shorter or longer period of time and sits on the professional council of the Development Center of Icelandic Healthcare.

Súsanna Ástvaldsdóttir, chief physician of health care in the northern region and district physician of epidemiology

Updated March 25, 2022 (GÓ)

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