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As health care organizations seek innovative ways to change financing and delivery mechanisms due to escalated health care costs and increased competition, drastic changes are being sought in the form of re‐engineering. This study discusses the leader's role of re‐engineering in health care. It specifically addresses the reasons for failures in re‐engineering and argues that success depends on senior level leaders playing a critical role. Existing studies lack comprehensiveness in establishing models of re‐engineering and management guidelines. This research focuses on integrating re‐engineering and leadership processes in health care by creating a step‐by‐step model. Particularly, it illustrates the four Es: Examination, Establishment, Execution and Evaluation, as a comprehensive re‐engineering process that combines managerial roles and activities to result in successfully changed and reengineered health care organizations.

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