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This article describes the strategic planning process used by a major academic medical center to redesign the employee health service. The steps in the process are discussed and data demonstrating the success of the program redesign are presented. P rior to the initiation of strategic planning, the occupational health program for the two hospitals in an academic medical center focused on post-offer physical examinations, triage of work-related injuries, and blood-borne pathogen issues. Any injury beyond first aid was referred to community physicians for treatment. Hours of operation were limited and the existing program did not address the needs of a 24/7 medical center and children's hospital for prevention or employees returning to productive work and associated costs of disability.