A suoervisor's review of existing programs offered by the occupational therapy department in a large teaching center led to realization that a swallowing dysfunction program then in place was not achieving the results, in quantity or quality, which department standards demanded. This is an account of the steps this supervisor took in planning how change could be implemented. This included identifying particular problems, specifying needs to correct them, determining staff and resource demands required, preparing others involved in the care of the targeted patient populations for the problems that could be created by introducing new program protocols and procedures in an established service.