Some of the most important decisions within a health care system are made in the administrative offices and boardroom. Executive leaders consider strategy, finances, quality, safety, technology, staffing, and the future of their organizations. But ultimately, those decisions come back to one place: the bedside, where clinicians care for patients and where patients and families experience health care firsthand. We sat down with a member of Washington Health’s executive team, Terri Hunter DNP, MPA, RN, NEA-BC, CENP, to get her insights into who has a voice in health care.
In her role as Vice President and Chief Nursing Officer, Hunter leads nursing strategy and oversees a broad range of clinical and patient care services across the health system from the hospital units to the level 2 trauma center. She leads the organization’s Magnet recognition and champions the empowerment of nurses to participate in decision-making at every level. Central to her leadership is being present, listening carefully, advocating for frontline teams, and making sure their experiences inform organizational decisions.
“We do frequent rounds with those who are at the sharpest point of patient care the people working directly with our patients every day. It is important to listen to their experiences, ideas, concerns, and what they need to do their best work,” said Hunter. “But it can’t stop with listening. It is my responsibility to carry those perspectives into executive and boardroom discussions.”
A dashboard on a hospital administrator’s monitor may reveal that a particular metric has changed. A report might identify a delay, an increase in incidents or an opportunity for improvement. But the people working at the bedside can often explain what is behind the numbers.
“As leaders, we often get a snapshot in time. We can round, review data, and hear reports, but the people actually doing the work have something we don’t always have – context,” added Hunter. “They have firsthand knowledge of the complexity of the work, the processes that make care easier or harder, and the small barriers that may never show up on a report or dashboard. That frontline perspective helps leaders understand not only what is happening, but why it is happening.”
Patients and Families Bring an Essential Voice
The importance of bedside presence is not limited to clinicians. Patients and their loved ones are at the core of the conversation and have context that cannot be captured in dashboards or reports. They experience the system not as a collection of departments and processes, but as people seeking care during some of the most critical moments of their lives. Whether they are being triaged in the Emergency Department, preparing for surgery, or discussing a condition with their primary care physician, patients and those closest to them are the ones whose perspective may be less tangible and most insightful to the people providing care.
Patients and their families are often the people who know the patient’s “normal” best. They can provide information the medical team may not otherwise have, such as usual behavior, allergies, mobility, eating and sleeping schedules, medications, symptoms, and previous reactions to treatments which can be clinically important.
If you are a patient or family member serving as their representative, your voice is invaluable. Follow these guidelines to provide the most pertinent information, advocate effectively on their behalf, and make sure you understand the plan:
- Answer questions fully with as many relevant details as possible. Provide specifics on when symptoms started, how they differ from the normal baseline, whether this is new or recurring, and anything else that can fill the caregiver in on the patient’s condition.
- Write things down to track information coming from different people and departments. Keep a simple record of things like your questions, names of key care team members, tests and procedures, medications administered, and follow-up plans.
- Ask questions about the diagnosis, treatment, risks, and plan going forward. You do not need medical expertise to represent yourself or your loved one. Make sure to ask for more details or a clearer explanation if you don’t understand something.
The voice of health care is strongest when frontline caregivers, patients, and families work together. Frontline staff bring clinical expertise and firsthand knowledge of the care environment, while patients and families bring the unique perspective of the patient’s needs, experiences, values and condition. “When these voices of experience and expertise are communicated upward through our health system, it results in safe, effective, patient-centered health care,” concluded Hunter.
For more information on Terri Hunter and Washington Health’s nursing force, which has received four consecutive Magnet recognition designations for nursing excellence, see pages 14-19 of the 2025 Annual Report at washingtonhealth.com/aboutus/annualreports.