How a community teaching hospital is changing to better serve its community.

In recent years increased attention has been focused on the importance of teaching hospitals' serving the health of their communities. A community teaching hospital may have a special impetus and some advantages because of its linkage to a defined geographic community and a traditional mission of providing clinical and other services to that community. The authors describe how their community teaching hospital, the health and education services network it belongs to, and the integrated delivery system of which it is a member work together to respond to the current challenge to provide care and education to local communities. In particular, they describe how since 1995 the hospital has used an approach (called Measurably Enhancing the Status of Health) to create and operate its new Department of Community Health and Health Studies and associated new programs to benefit the community. The new department combines innovative community outreach programs with an emphasis on the qualitative and quantitative evaluation of the these programs. There are also programs of medical education in the hospital and at the Pennsylvania State University College of Medicine, and other programs that have community educational components (e.g., a coalition to reduce the number of smokers; a center to reduce health risks and prevent disease). The authors and their hospital colleagues have found three concepts to be helpful as they reflect on what they have learned since 1995 and continue to refine their community outreach work: community, complexity, and collaboration/competition. They explain these concepts and suggest that other institutions in academic medicine may find them and the ideas and programs of their hospital useful as the seek ways to care for, educate, and measure the health status of their own communities.