The demographics of the North of Carolina: Vidant Medical Center

The demographics of the North of Carolina: Vidant Medical Center

Introduction

This article discusses the demographics of the North of Carolina focusing on aspects like the its population and the growth rate of the population. North Carolina is the 28th largest state in the United States and the 15th in terms of population density. The article continues to discuss the   Vidant medical center, the largest Trauma level I hospital in North Carolina and the process of projecting long-term financial performances of individual departments within the medical center. The objectives of the medical center involves the capacity of the center to sustain long-term operations while making use of periodic comparisons with the real outcomes of operating capital and cash budgets. The article recognizes the importance of financial professionals in the creation of budgets which are used by the Vidant Medical Center management body.

According to Census, (n.d), the state of North Carolina has experienced a healthy population growth rate over the last eight years. As of 2018, the population of North Carolina stood at 10,383,620 people a 1.13% increase from 9,535,483 people in 2010. However, the population of North Carolina has reduced the rate at which it is growing since the previously recorded population growth between 2000 and 2010 was at 18.5% (Census, n.d.). North Carolina is the 28th largest state in the United States with an area of 53,819 square miles and an average population density of 196 people in every square mile making it the 15th most densely populated state (Census, n.d).

According to Factfinder, (n.d), and the median age for North Carolina’s population is 38.4 years of age with an estimated 51.4% of residents as female and 48.6% as males. North Carolina accommodates people from a multitude of races with the majority as the white race at 63.1% of the North Carolina population. African Americans make up 22.2%, Hispanics constitute 9.5%, and other races make up 3% and Asians 3.1% (Census, n.d). Also, the Native American population in North Carolina is 1.6% with two to three other races making up 2.3% of the North Carolina population. Religion is an essential part of the community, and the overwhelming majority of North Carolina residents are Christians who represent 77% of the population. 3% have identified with other religions that are not Christian with 20% of the population lacking any religious affiliations (Census, n.d.). As of the year 2017, 12.6% of the population in North Carolina did not have health insurance coverage, and 9.6% of the population under 65 had been diagnosed with various forms of disability. Research also found that 16.1% of the population of North Carolina lives below the poverty line. Further research also shows that the white race is the least poor, followed by Islanders, then the African American race, with the Hispanic race being the poorest.

According to research the population of North Carolina is prone to cancer due to the large-scale production of tobacco and brick, exposing the community to various risk factors associated with cancer. This was backed by research showing that cancer is the leading cause of death in the State of North Carolina and is most common among the population above 65 years of age (ACS, 2018). Research conducted by the CDC (2016), indicates that and obesity and being overweight is another issue in North Carolina with 35.9% of the adult population falling under this category. In the words of ACS, (2018) the rate of cigarette smoking is at 35% while the level of obesity lies at 32% in addition to a high incidence rate of about 465 people has prompted the State of North Carolina to address healthcare in the state which has declined. According to the CDC (2016), North Carolina State has already established the State Public Health Action Programs to help deal with the health issues within the state. The state in conjunction with the department of transportation managed to develop active routes to school with the aim of encouraging the youth to walk and or bike to and from school. This served the purpose of increasing the level of physical activities among the population. The state was also very instrumental in easing the accessibility of the farmers market to the disabled within the community.  Some agreements between the state of North Carolina, public spaces, parks, and churches were established for the facilitation of the recreational activities (CDC, 2016).

Data collected indicates that there are limited programs for educating the public thus, the state of North Carolina has the opportunity to create and implement public awareness programs with the aim of engaging the community on the risk factors of cancer and how to lead a healthy life to prevent cancer.

Budget Analysis

Research showed that North Carolina is a big state with a dense population battling some health issues. As a result, it needs a state of the art medical facility to cater for the health needs of North Carolina’s population. Vidant Medical Center was recognized as one of the leading healthcare service providers in the state of North Carolina. Research shows that for Vidant Medical Center to work as it was meant to it requires a process of projecting the long term financial performance of various departments within the center whereby specific objectives are set. According to an assessment of the center conducted in 2009, Vidant Medical Center provides Level I Trauma Services in addition to holding a license that allows the center to cater for approximately 861 patients across the state of North Carolina. The same assessment shod that Vidant medical center had an admission rate of 39,000 patients from all over the state of North Carolina. Hofler and Thomas found that of the 861 patients that the Vidant Medical Center is licensed to cater for, the general department has a capacity for 734, and the rehabilitation department holds 75 patients while the psychiatric department holds 52 patients. The Vidant medical center has 35 surgical rooms which share both ambulatory and inpatient surgery departments that total up to 26. The medical center also has C-section, endoscopy, and inpatient rooms (2016).

Research indicates that as of the year 2015, Vidant Medical center had about 300,000 employees under its mandate, with more than 300 beds giving the center capacity to handle more than 1.4 million patients from the state’s 29 counties. According to Hofler and Thomas (2016), the size of Vidant Medical Center made it the third largest Level I Trauma Center in the country. The Vidant Medical Center has multiple integrated networks tasked with the oversight of more than 165 medical centers and over 1000 outpatient locations. Researched by Hofler and Thomas (2016), affirms that the Vidant Medical Center offered medical care to over 6.7 million trauma patients in the year 2015. Further research by Hofler and Thomas (2016), indicated that the state of North Carolina expects an influx of veterans coming home from war-torn areas of Iraq and Afghanistan. As a result, the Vidant medical center is poised to expand to cater for the mushrooming aging population of veterans in addition to providing for the demand for health services in the larger North Carolina area. Research indicates that the Vidant medical center has experienced some long-standing challenges with giving veterans access to medical care. Other problems plaguing the Vidant Medical Center include unreliability in scheduling appointments for patients, which eventually leading to congestion of the Medical Center. The inadequate coordination of care for veterans between Level I Trauma Services and non-Level Trauma Services medical providers, which contributed to the passing of thee veterans Access, Choice and Accountability Act in 2014 by Congress commonly known as the choice Act. The Choice Act made funding available in addition to other resources with the aim of assisting in the support and reformation of the VA (Ang, Sabharwl, Johannson, Bhattachrya, & Gupte, 2016).

The choice Act of 2014 made sure that it included a function which allowed the VA to contract with private organizations to conduct an assessment of the healthcare system independently. This evaluation included a review of 12 sectors with the system healthcare delivery and management procedures. According to Ang et al., (2016), the evaluation procedure also includes the competency of the leadership of the Veteran Health Administration in regards to performance appraisal, accountability, and succession foresight and employee engagement. The research found that for the Vidant Medical Center to make these plans a success there is a need for the formulation of a design and development budget with the aim of leveraging human capital.

Research from the North Carolina Medical Board indicated that the workforce of Vidant Medical Center had been the single most defining factor behind the success of the center as a leader in the provision of medical services in addition to the capacity that it has to perform and a representative it the centers medical center.

According to research, the action consisted of procedures, which Vidant Medical Center required to attain a capable system. The action plan also sought to demonstrate many significant developments such as delivery of service, and the experience of patients in the areas of access of treatment and support for the elderly and primary care (Price, Beilman, Fabian, Hoyt, Jurkovich, Knudson & Phillips, 2016). According to Dyas et al., (2015), the action plan also identified other priorities such as the creation of a working environment which enhances excellence that late translate to the maximization of health care management and profits.

Ang et al., (2016) define a budget as a quantitative statement which is prepared for approval before the purpose of the definition of duration. The scope of a budget contains measures deemed appropriate to respond to all the companies’ functions. Management control consists of various interlinked elements such as the personnel tasked with the responsibility of monitoring, analysis of income statements and analytical accounting (Smith et al., 2016).

The healthcare manager at Vidant Medical center is responsible for presenting the center with a procedural-orientation towards confirmation of the status of advancement of the goals planned. The HIM is also responsible for submitting the organization’s efficiency in terms of taking an analytical approach towards resources, costs, and proceeds (Ang et al., 2016). According to Price et al., (2016), the HIM was also involved in considering the external and internal guidelines of Vidant Medical center, while programming initiatives formulated for the attainment of planned goals.

Before the budget was considered the Vidant Medical center ought to have calculated the salaries of employees and any related tax deductions for ascertaining the money available for the medical center to the source. The calculation done by the Carolina Medical Board revealed that the salaries of employees at the Vidant Medical Center stood at 59% of the wage standard of the state for medical and support staff with the tax deductions holding $10,951 (Bruch, 2016). Thus, an observation was made that for Vidant Medical Center to create a budget for expansion they had to ensure that all expenses in addition to the daily operations were coverable.

After an analysis of the budget, the next step into facilitating the expansion of the Vidant medical center is making a budget plan.  As a Medical Center Vidant had to outsource the budget plans for the HIM and the rest of the centers’ management to use. The finance teams hired for the budget planning had to make sure that they understood the bottom line benefits of containing costs in addition to the process of improving initiatives (Miller, 2018).

The managers of Vidant Medical Center established the budgeting objectives of the center. The center had to fully staffed and equipped; it had to be supplied with healthcare tools for accreditation purposes. The budget developed budget for the medical supplies had to consider the initial medical supplies cost which the HIM was responsible. The manager also had to conduct a rolling forecast for the creation of a multi-year plan to facilitate the development of a detailed budget. The rolling forecast required an 18month projection which made it possible for the manager to assess the current realities, which would influence multi-year projections, inclusive of operational plans.

Budgeting strategies were the first considerations in making sure that the Vidant Medical Center achieved its goals and objectives. The manager of the medical center was mandated to enhance the strategies of each department considering what would benefit the departments. The manager had to calculate the total income by identifying the intensity of the workload of each department based on statistics (Acuity Adjusted Patient Days, Weight RVUs). The manager also had to estimate the overall expenditure of the medical center putting into consideration fixed costs like staff training and inflation issues among others. The manager had to employ the cross-departmental initiative based model to calculate the overall expenditure of the Vidant Medical center (Dunham-Taylor, 2014).

Based on the budget provided there was a need to create a culture of feedback and transparency among the healthcare givers in the medical center. The manager had to work closely with employees to increase the feeling of openness, which enabled the employees to utilize the available resources provided for in the budget (Landry et al., 2016).

The Vidant Medical Center published high-quality content on its website in regards to the budgeting strategies which other healthcare systems used to view the process used by the Medical Center to utilize each of the steps efficiently. An alignment of the financial plans and business realities helped to unify the platform of management performance, the design of the entire healthcare system and the delivery of sophisticated reports which showcased the decision and planning as one solution. An action plan was then used in the determination of the goals of the medical center, the assessment of roles, the development of the budgetary policy, implementation of the developed budgetary plans and the evaluation of the plan used for the implementation of the strategy.

Conclusion

Following the budgets prepared for Vidant Medical Center helped them achieve their strategic goals and objectives, which are improving their care for the veteran community and at the same time support the expansion of the Medical center.

 

 

 

 

 

 

 

 

 

References

ACS (2018). Cancer facts and figures. Retrieved from

https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-    statistics/annual-cancer-facts-and-figures/2018/cancer-facts-and-figures-2018.pdf

Ang, W. W., Sabharwal, S., Johannsson, H., Bhattacharya, R., & Gupte, C. M. (2016). The cost     of trauma operating theatre inefficiency. Annals of Medicine and Surgery, 7, 24-29.

Bruch, R. (2016). A sea change in medicine current shifts in the delivery and payment of medical     care. North Carolina medical journal, 77(4), 261-264.

 

CDC (2016). Nutrition, Physical Activity, and Obesity Profile. Retrieved from

https://www.cdc.gov/nccdphp/dnpao/state-local-programs/profiles/north-carolina.html

Census (n.d.). North Carolina. Retrieved from https://www.census.gov/quickfacts/nc

FactFinder (n.d.). North Carolina Community factors. Retrieved from

https://factfinder.census.gov/faces/nav/jsf/pages/community_facts.xhtml?src=bkmk

Dyas, S. R., Greenfield, E., Messimer, S., Thotakura, S., Gholston, S., Doughty, T., … & Phillips,     R. (2015). The process-improvement cost model for the emergency department. Journal     of Healthcare Management, 60(6), 442-457.

Dunham-Taylor, J. (2014). Financial Management for Nurse Managers-Merging the Heart with       The Dollar. Jones & Bartlett Publishers.

 

Hofler, L., & Thomas, K. (2016). Transition of new graduate nurses to the workforce challenges     and solutions in the changing health care environment. North Carolina medical journal,     77(2), 133-136.

Landry, S., Beaulieu, M., & Roy, J. (2016). Strategy deployment in healthcare services: A case      Study approach. Technological Forecasting and Social Change, 113, 429-437.

Miller, G. (2018). Performance-based budgeting. Routledge.

Price, M. A., Beilman, G. J., Fabian, T. C., Hoyt, D. B., Jurkovich, G. J., Knudson, M. M., … &     Phillips, M. J. (2016). The National Trauma Institute: Lessons learned in the funding and     conduct of 16 trauma research studies. Journal of trauma and acute care surgery, 81(3),     548-554.

Smith, S. L., Price, M. A., Fabian, T. C., Jurkovich, G. J., Pruitt Jr, B. A., Stewart, R. M., &     Jenkins, D. H. (2016). The National trauma research repository: ushering in a new era of     trauma research (commentary). Shock, 46(3S), 37-41.

 

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