Strategic planning has traditionally been a business activity, in which an analysis of market forces and organizational mission leads to major business goals for the future, from new programs and services to entirely new facilities, systems, and even new organizational models. The integration of TQM principles focuses strategic planning more on meeting the needs and expectations of customers and less on emulating the competition, and it aligns strategic initiatives with improvement efforts. In this Perspective, William Corley says that, once TQM and strategic planning have been integrated, the next phase is both necessary and inevitable: focusing strategic planning and improvement efforts around community health needs. But what will it take to make the paradigm shift?