The article focuses on health care facilities. These facilities are facing financial pressures as the federal government, managed care, and the shift to outpatient care forces downsizing and hospital closures across the nation. This financial pressure translates for many institutions into an increased emphasis on financial metrics to the exclusion of other parameters. This article explores the three year journey to organizational and financial health of Bridgeport Hospital, a member of the Yale New Haven Health System, using the balanced scorecard as a strategic tool.