When an organization disappoints its community, the trust and goodwill between them are harmed. The Pittsburgh area has experienced a painful situation because of the bankruptcy of Allegheny Health, Education and Research Foundation.
Finger-pointing is inevitable but will accomplish little. Instead, other healthcare organizations should learn from this experience and prevent similar situations.
Preventive action is especially important now because recent polls reveal a pattern of deteriorating relationships between healthcare organizations and their communities nationwide.
The trustees of healthcare organizations should strengthen the vital relationships between their facilities and the people they serve. One way they can do this is by conducting regular "civic audits" of their organizations and reporting the results to the public.
To be useful, these audits must reflect what members of the community expect from the organizations and show what the organizations are doing to meet expectations.
The audits can be built on these questions, and results can be reported to the public:
* Does our organization pursue its core mission to enhance health broadly?
A good relationship with the community is based partly on fulfilling the purpose for which the organization was established.
Quality services certainly contribute to community health. However, organizations should view health based on the community's physical, social and economic environments, and the lifestyles and behaviors of its citizens.
* Have we defined and met our economic obligations to the community?
Healthcare organizations make significant economic contributions. Although Pittsburgh is home to Aluminum Company of America, Heinz, USX Corp. and many other corporations, its healthcare organizations employ more people locally than the corporations do.
Furthermore, the economic contributions of healthcare organizations exceed the ripples made by paychecks. Financially sound healthcare organizations can share the burden of community infrastructure through taxes or payments in lieu of taxes. By producing value in their services, these organizations can help attract people to the community and retain them.
* Do we help our community through the way in which we pursue our mission?
Healthcare organizations can provide charitable services and subsidize costly but unprofitable services such as burn units or primary-care clinics in neighborhoods with high poverty rates.
Facilities can also provide more subtle benefits by reporting substandard clinical practices to authorities, ensuring that impaired practitioners get help, educating consumers about health matters, allowing broad and diverse community representation on boards of trustees and asking consumers to participate on advisory panels or community forums.
* Are our corporate social responsibilities and philanthropic activities as broad and as generous as our circumstances permit?
Some healthcare organizations can make significant philanthropic contributions locally by following the three P's of philanthropy: Perceive the unmet needs in the community, prioritize those needs and partner with others who take their civic roles seriously.
Effective partners can be readily found in the business, public, foundation, labor, education and religious sectors. Other healthcare organizations can also be good partners if they are strongly committed to corporate social responsibility and have similar views on philanthropy.
* Do we comply fully with our legal and fiduciary requirements?
Trustees must ensure that their organizations obey all laws and honor all obligations established by law.
* Have we fully met our ethical obligations?
By operating ethically, an organization tries to embody and even raise the moral values in the community. For example, ethical operation would be reflected by establishing a hospice program or disposing of medical waste as safely as possible. The organization must ensure justice, honesty and fairness in all interactions, whether with patients, employees, competitors, suppliers, regulators or the community.
Adhering to high ethical standards also means practicing economic efficiency-for instance, by building healthcare facilities that provide for technical quality, patient comfort and reasonable amenities but not ostentation.
By answering these questions, taking corrective action or filling in the gaps identified by the audit, and reporting the results to the public, trustees will be doing more than reciting platitudes about their commitment to the community. They will convey specifics about their organization's contributions to civic life. In the process, they may strengthen the foundation for enduring relationships with the community.
Beaufort Longest is a professor and director of the Health Policy Institute at the University of Pittsburgh. A version of this "Commentary" was published in the Pittsburgh Post-Gazette.