Question: Comment 1: Health care reengineering is a discipline that helps organizations reorder priorities, provide more cost-effective care, and increase value to customers. Reengineering should be driven what is best for the organization and the needs of the organization. Reengineering is a critical "core competency" and "requisite skill" for health care organizations if they are to succeed under managed care in the future. Managers and leaders play a vital role in the process of reengineering. The managers role is to ensure "that the mission of the organization, which focuses on providing excellent care for clients, is fulfilled through effective and efficient coordination of resources" (GCU, 2013). Managers display the skills for showing responsibility by guaranteeing that the staff is competent to provide the care of each individualized patient. Managers show their skills by holding staff accountable. Managers have been described as planners, problem solvers, delegators, and staffers (Huber, 2014). GCU, 2013, described the roles of management as planning, organizing, staffing, directing, and controlling. Leaders are the mentors and inspirations of the organizations. The leaders make the goals and outcomes known for the organization. The leaders are critical to organizations as they ensure that the operations than run from day-to-day are ran smoothly without any bumps in the roads. Managers and leaders have distinct roles with their organization but they both must integrate their roles to provide effective leadership. The managers and leaders work together to develop the "power" needed to accomplish goals, mission, and reengineering within the hospital.

Comment 2: Nurse managers and leader's role in reengineering health care is by being advocates for patients and staff, as well as making sure the hospital's environment is calm and functioning smoothly. "Advocacy is a process used to facilitate growth in others. Common methods of advocacy are: 1) providing others with information that empowers them to make their own decisions, and 2) acting on behalf of others who do not have the ability or power to advocate for themselves" (Reengineering, 2011). It is important for the nurse managers and leaders to create a hospital facility environment where patients are respected, and are empowered by educating them on their health and condition to enable them to make decisions about their treatment and care. It is also important for managers/leaders to continually check on their staff's patient care feedback and any concerns they may have. It is also important for them to listen to their staff and patient. "Leaders must listen to the sounds of change. Leaders must help people work through the grieving process and conflicts experienced during time of change. Because the pace of change in health care is so rapid, leaders must be prepared to deal with the chaos and uncertainty through calm communication" (Reengineering, 2011).