A service survey was sent to service recipients of HSA through the Saga-symposium system with a text message to those who sought service at HSA. A survey could also be answered through a QR code on an information card. The results of the survey are presented on a scale from 1 to 5 where 5 is the best possible outcome and 1 the worst. A total of 3,089 responses were received, but the survey could be answered in Icelandic, English and Polish. Most of those who answered the survey were residents in rural areas, answered in Icelandic, were women and over 65 years of age.

Results

Overall, HSA performed well in terms of service and interface and was above average compared to other institutions. HSA scored lowest in terms of service speed but was higher compared to other institutions. With reliability of information, the results were similar to other institutions. If the correlation of service factors with overall satisfaction with service is examined, HSA is performing well in terms of interface and reliability of information but is below the benchmark in service speed. Here the quality criterion is set at 4,2 and above.

HSA services

Overall satisfaction with HSA was very good, 90% of respondents thought HSA service was very good or rather good, and almost 4% experienced rather bad or very bad service at HSA. By comparison, 83% of respondents at other institutions thought they were getting good service.

“Service as good as you can imagine.” “Simply good service.” “Great and professional service.” “Just thank you for me!” “Thanks to you, I don’t often get service at HSA, but when it is needed I meet good attitude, smoothness and professionalism of all the employees that are coming.”

If we look at the answers of participants by background variables, HSA is better compared to other institutions, except for younger people and Polish speakers. Especially noticeable is that individuals based in the capital area seem to think that HSA services are generally better than other institutions: “Never had such quick and good service as at HSA and I have lived all over the country. Really satisfied.” “ Hadn’t gotten better service in the capital area.” “ This is the best service I have had so far.”

The most important issue regarding the service is location, i.e. having to leave their home area to attend the service: “Could there be a doctor every day in the health care so I don’t have to be driving endlessly between places”. There were also some suggestions that it would be good to have a regular doctor, not always having to meet a new one every time you arrive: “Mostly not regular doctors and you meet a new doctor every time.” Similarly, some people thought that there was a lack of specialist services and appropriate equipment so service recipients don’t have to travel between parts of the country to attend that service: “Would need better tools for GPs to work with. And more specialist doctors to work abroad”. Although there was a request for a strong specialist service abroad, there was a great satisfaction with the specialist services offered at HSA: “I needed eye checks and it is absolutely invaluable to have access to this service here in Egilsstaðir.” “It is a great benefit to get an examination from specialists [...] but not to need to go to Akureyri for a short interview.” Another point that was pointed out that could be better was follow-up and have more communication and information through health care centres such as the results of research: “Welcome to the results of blood tests being available at Heilsuvera. Then you don’t have to spend time ordering a doctor’s interview, unless the doctor thinks it is important and then it will be made available at Heilsuvera.”

Staff interface

The staff of HSA receives very good recommendations in general but in total 96% of respondents believed that the staff’s attitude was good and only 1% experienced a bad attitude from the staff of HSA. By comparison 90% of respondents at other institutions believe that their staff has a good attitude.

“The staff is wonderful.” “Great friendly staff.” “The staff is very decent and helpful all the time.” “The staff at HSA is a team of people up to groups.” “Great people working at HSA.” “The attitude of all the staff was in all places warm and generous. I am deeply grateful for having been in their hands when I needed good people.” If the results of the survey are examined by background variables, HSA is better compared to other institutions on all aspects except for service recipients with foreign citizenship. Usually the staff was praised highly and service recipients thanked them very much. However, it was found that individual participants experienced that they were not listened to and others had difficulty not having an Icelandic speaking staff to take care of them.

Reliability of information

The results of this section of the survey are comparable to what is happening at other institutions. HSA seems to be doing a good job in terms of reliability of information to clients, scores 4.3 points out of 5 possible.

If the results are examined by background variables, individuals living in the capital area seem to be most satisfied with the reliability of information at HSA, at least compared to other institutions. However, HSA is worse off than other institutions in terms of foreign citizens and those who are Polish speaking. Otherwise, this is similar to other institutions.

Speed of service

This was the factor most people expressed dissatisfaction with, it is waiting time for service and this is the only part of the survey that HSA scores below the quality criteria or 4.0 out of 5 possible points which is higher compared to other institutions, 3.8. About 77% of respondents think that HSA service is going very fast or rather fast for themselves, while 71% think it is going for other institutions. 11% of respondents thought that the service was going rather slow or very slow.

However, some expressed their satisfaction with the quick and good service at HSA: “Very grateful for good and quick service.” “I live in Egilsstaðir and have often had to get service from the healthcare center there. Very friendly staff, both in reception and healthcare staff. Top service, can get to you quickly and call back quickly if you ask for a call.” “Doesn’t go to the doctor often. Fancy work and call and get time a few hours later and medicine afterwards. 2 days later it’s good.” However, there were more people who expressed dissatisfaction with waiting times for appropriate service and/or resolution of their cases: “Nothing wrong with the service, just difficult to get time from a doctor and the same doctor difficult not being able to have your doctor there can be a long and difficult wait.” “Is satisfied with the service I have received. But like everyone who has to wait for it, it has consequences.” “Rosaly waiting for everything and difficult to get simple answers.” “Doesn’t think there is a need for more speed in diagnosis, not talking about looking at the status after ca. a day again.” “Time reservations from the doctor take a little time, a week or so. It would be very good if the waiting time for time was shorter.”

If the results are examined by background variables, HSA scores better on the service rate in all categories except for the Polish speaker, when compared to other institutions. In addition to these factors, younger people and women score lower in this respect.

Summary

From these results it can be assumed that HSA is providing good service compared to other institutions. HSA staff is praised for good service, kindness, helpfulness and professionalism. There was a special appreciation towards the receptionist for warm and helpful instructions. It also seems that HSA is on the right track regarding increased specialist services, a mental health team as well as a change in procedures to shorten waiting times, such as the nurses’ quick response: “From my encounters with ambulance workers, hospital workers and healthcare centres and especially the mental health team that was set up, all wonderful and top people that need to continue here. Thank you”. “ Satisfaction with nurse’s preparation for the doctor’s interview, not done before.”

The most critical aspects of the service are not having a regular doctor and lack of follow-up. Many felt it was difficult not to get service in their hometown and others felt they needed appropriate equipment and specialist services to not need to leave the quarter for research. Some also felt that waiting time for service was difficult for many and requested to increase the number of doctors in the quarter as well as expand specialist services, even increased telehealth services.