During the last decade ambulatory practices hospitals and health systems have begun to adopt innovative management strategies and systems engineering tools to improve their health care processes (Hostetter 2008). Huber (2010) states that reengineering is a way of dramatically redesigning how a business operates and functions. In order to do so several different important key factors are analyzed at different angles and from different points of view. Consideration of the consumer is factored into the changes as well as the desire to achieve care that is of high quality low cost and consistent with fast and friendly efficiency (Huber 2010 p420). With that said nurse managers and leaders are a vital contributory source of influence when it comes to planning an organization that is focused on delivering high quality nursing care. For example Huber (2010) lists several leadership behaviors that are commonly expected in the role of reengineering and include motivating the group to restructure ensuring the existence of nurse representation throughout the restructuring process and using interpersonal skills to engage those who share an interest in the business. Similarly management also plays a vital role in reengineering by providing authority to match responsibility monitoring the potential strain and stress caused by the uprooting of old practices negotiating standards and expectations and so much more (Huber 2010 p421). The bottom line is that reengineering of health care can bring about a significant amount of positive changes such as cost savings and increased productivity without compromising patient care and satisfaction (Hostetter 2008). Furthermore such a seemingly large task cannot be successfully completed without the guidance and assistance of management and leadership.