Hospitals, Community Health, And Balanced Scorecards‪.‬

INTRODUCTION Since at least the mid-1990s, hospitals have been urged to take responsibility for improving the health status of their communities. This has come from health care management literature (e.g., Campbell, 1998; Griffith, 1997; Olden & Clement, 1998; Shortell, Gillies, Anderson, et al., 1996; Sigmond, 1995), professional organizations including the American College of Healthcare Executives, American Hospital Association, and the Commission on Accreditation of Healthcare Management Education, and prominent health care executives themselves (McNerney, 1995; Newbold, 1995; 1998). Shortell, Gillies, Anderson, et al. (1996) suggested that hospitals should shift to provide both public/community health care and institutional/traditional health care, and doing so would mean hospitals must evaluate community health status to make improvements and provide services meeting community needs. Fos and Fine (2000) asserted that hospitals have a social responsibility to their community to improve public health. They believed that understanding community health status is a success factor for health care executives and their hospitals in the twenty-first century because in order to plan, organize, and deliver services to the community, they must first understand community health status. These authors urged health care executives to shift toward a more external focus. Hospitals have begun to do that by becoming more involved in community health assessments and creating programs to improve community health. This is especially true of not-for-profit hospitals that contribute to their communities to maintain tax-exempt status.