Innovative Roles Journal of Addictions Nursing & Volume 26 & Number 2, 106Y108 & Copyright B 2015 International Nurses Society on Addictions

An Interview With Lisa Clark, MSN Editor: Joan Kub, PhD, MA, PHCNS, BC, FAAN

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recently attended the Recovery Month Planning Partners meeting in Washington, DC, and had the opportunity to meet Lisa Clark, Vice President of Marketing and Development at AdCare Hospital in Worcester, MA. Ms. Clark earned a Bachelor of Science in Nursing and a Master of Science in Community Mental Health Nursing from Boston University. She is currently a senior marketing professional with progressive leadership in marketing/sales, government relations, management, and clinical care. She has experience in healthcare, addiction treatment, and pharmaceuticals and drug testing, working with diverse institutions and market segments local to national scope. In a recent interview, it was my pleasure to learn about her varied roles across her career and in her current position. She has navigated an innovative career path, integrating business with her clinical nursing experiences to lead health systems in addressing addiction. I AM INTERESTED IN LEARNING MORE ABOUT WHAT BEING ‘‘A SENIOR MARKETING PROFESSIONAL’’ MEANS WITHIN ADCARE HOSPITAL A senior marketing professional is concerned with looking at the marketplace and promoting the services of an organization to meet healthcare needs. I am currently employed at AdCare Hospital of Worcester. My department is concerned with educating others and assuring that the services provided are evidenced based, adequate, and cost effective. Marketing professionals follow the four Ps to guide thinking and planningV product, price, position or place, and promotion. The product is the actual behavioral health service provided. We are concerned with several questions. What do patients, families, referents, and the larger community need? How can we best meet their needs? Is the service provided evidenced based? Members of our department participate in a quality assurance process and are concerned with customer satisfaction and quality. In considering the pricing, we are interested in who the consumers of the services are, whether they have access to care, and whether the service is affordable. Regulations are critical in this equation. Position is concerned with where the services are offered, geographically and relative to other options in the

School of Nursing, Johns Hopkins University, Baltimore, Maryland. The author reports no conflicts of interest. The author alone is responsible for the content and writing of the article. Correspondence related to content to: Joan Kub, PhD, MA, PHCNS, BC, FAAN, 525 N. Wolfe St., Baltimore, MD 21205. E-mail: [email protected] DOI: 10.1097/JAN.0000000000000080 106

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marketplace. Promotion is concerned with education and raising awareness of particular services and their effectiveness. We’re particularly interested in the need to educate about behavioral health. Education is core, and the challenge is how to make it digestible. It’s important to ‘‘normalize’’ behavioral health concerns and substance use disorders as health concerns that touch almost every family in some way. Providing alternative perspectives that correct the usual social stereotypes helps people see the need for and value of behavioral health services.

Q: A:

WHAT ARE YOUR CURRENT ROLES AND RESPONSIBILITIES?

I’m currently responsible for the business development, marketing, and community services of a 114-bed hospital providing medically managed and medically monitored withdrawal from addictive substances as well as inpatient rehabilitation; six outpatient clinics treating substance use disorders; and a 46-bed residential treatment site providing detoxification, crisis stabilization, and rehabilitation. My role is varied and includes managing a team of community services representatives with backgrounds in health, human services, and substance use disorder recovery, serving in different geographical areas raising awareness of inpatient, residential, and outpatient care options. Our community service representatives do a lot of work in the community with education, collaborating with other healthcare providers and advocating for behavioral health awareness and access. They serve different geographical areas representing various levels of care. My position also oversees the efforts of the admissions departmentVthese folks are the first to answer the telephone calls from people in crisis; they sort out the insurance and financial questions and handle the preadmission assessments, authorizations, and the logistics of admission scheduling. We’re also concerned with transportation services. Transportation can be a very real problem and barrier to receiving care. CAN YOU DESCRIBE YOUR CAREER PATH THAT LED TO THIS POSITION?

Q: A:

I started my career in inpatient psychiatric nursing working at several hospitals in Massachusetts and New York. My roles have included nurse psychotherapist, clinical coordinator/nurse manager, clinical nurse specialist, administrative nursing care coordinator, program director in both inpatient and outpatient psychiatry, substance use disorder treatment, and home care. I’ve also had the opportunity to participate April/June 2015

Copyright © 2015 International Nurses Society on Addictions. Unauthorized reproduction of this article is prohibited.

in research activities during my tenure at Massachusetts General Hospital. Initially, I worked at AdCare from 2000 to 2004 as a community services representative. This was followed by working for two pharmaceutical companies specializing in products treating addictive illness. In 2010, I became the Vice President of Business Development for a network of treatment facilities across the United States. My most recent position is that of AdCare Vice President. HOW HAS YOUR CLINICAL EXPERIENCE CONTRIBUTED TO YOUR ABILITY/CONFIDENCE TO TAKE ON THESE BUSINESS/MARKETING ROLES?

Q: A:

In thinking back to my preparation as a nurse, it is clear that the nursing process prepares a person to take on other roles in healthcare. For example, assessment skills and defining a problem in a careful way are critical to the work I do today. Planning and evaluation are important as well. When I went into sales, I found that the same or similar elements in the nursing process were being used in sales. Understanding the processes and stages of change, for example, is important. These issues inform the conversation about new innovations in healthcare. If one considers the need for regulatory change, for example, one has to look at how we got to where we are, where we want to be, why we want to be there, and how to best engage stakeholders while balancing their concern. Listening skills is critical, and a willingness to meet people where they are is needed. Readiness to change and motivation to change (or not) must be considered. There needs to be an exchange of ideas about what works in various settings. We need to draw on the realms of experience of others. We know, for example, that psychiatric units can look different in different settingsVwhat works in a free-standing private hospital psych unit won’t necessarily work in a unit in a major medical center serving a high proportion of public sector patients. To understand the systems at work, we need to consider a breadth of experience. The Drug Abuse Treatment Act of 2000 (a federal law permitting the office-based treatment of opioid use addiction with Food and Drug Administrationapproved medications, i.e., buprenorphine) is an example of a major federal regulatory change. A lot of work went into passing that legislation. Moreover, it had to be followed by even more regulatory and systems change to educate managed care organizations, health plans, prescription benefit plans, hospital pharmacies, therapeutics committees, and so forth to create meaningful access to this new treatment modality. WHAT ADVICE DO YOU HAVE FOR NEW NURSES WHO WANT TO COMBINE BUSINESS WITH THEIR NURSING WORK?

Q: A:

Don’t shy away from the notion of ‘‘business’’ in nursing or healthcare in general. We need to embrace

Journal of Addictions Nursing

the economics of healthcare, look at the big picture of the burden of disease and cost impact/offset of new evidence-based practices, and move forward in advancing healthcare with these discussions. Nurses can be key leaders in these discussions. I know I benefited greatly by attending internal trainings on budget, finance, negotiation, and so forth that had nonnursing participants from other hospital departments. They gave me more of a systems perspective. We need to develop training opportunities in institutions where individuals work. Working with other disciplines, professions, and community advocates on task forces and awareness projects outside our own organization further develops these skills. YOU HAVE HAD THE OPPORTUNITY TO BE IN MANY LEADERSHIP POSITIONS TO INFLUENCE CHANGE, SOMETIMES AT A POLICY LEVEL. CAN YOU TALK ABOUT A FEW OF THESE?

Q: A:

I’ve had the experience of being a registered lobbyist and have provided testimony to policy makers, state health plans, drug utilization committees, and pharmacy boards in matters related to disease prevalence, access to care, drug diversion, overdoses, screening, brief intervention & referral to treatment, and prescription drug monitoring. In addition, I have had an opportunity of being involved in several innovative technologies or programs throughout my career. These include (a) outpatient detoxification and intensive outpatient treatment of substance use disorders from a truly holistic medical perspective; (b) office-based opioid treatment using buprenorphine, a partial agonist/antagonist opioid; and (c) treatment of alcoholism using depot naltrexone, a full opioid antagonist delivered using nanotechnology. In the 1980s, I was program director of Pace Health Services in New York City. Our medical director was Dr. Nicholas Pace, who also served as the medical director of the General Motors New York City office. This program was one of the first to begin offering outpatient detoxification along with intensive outpatient treatment for patients who preferred to remain at home and/or at work and did not require an inpatient level of treatment. We were often in the position of contacting insurance companies to make a request that they flex an inpatient benefit to permit less costly treatment at an outpatient level of care. Lucinda Franks of the New York Times profiled the program in its Sunday Magazine in the mid-1980s, calling it the ‘‘wave of the future.’’ TELL ME ABOUT RECOVERY MONTH IN NEW ENGLAND. WHAT HAS YOUR AGENCY’S ROLE BEEN AND HOW WILL YOU BE INVOLVED IN THE FUTURE?

Q: A:

We have joined in local planning efforts so our staff has played many roles in recovery celebrations in our market area. AdCare has been a longtime sponsor of the www.journalofaddictionsnursing.com

Copyright © 2015 International Nurses Society on Addictions. Unauthorized reproduction of this article is prohibited.

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Massachusetts Organization of Addiction Recovery and a Recovery Month Celebration at the State House, along with recovering voter registration activities and so forth. Our Rhode Island Community Service Representative, Sue Shaw, supported Rhode Island Cares with their Rally for Recovery using her skills in working with broadcast media to raise public awareness. Many AdCare staff joined in the Worcester Cares Walk for Recovery and Celebration in one of the city’s public parks, featuring remarks from local policy makers, recovery community members, health information booths, and fun family events. Each of our community services staff support and

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participate in Recovery Month activities in the communities where they serve. AdCare co-sponsored the production of ‘‘The Anonymous People’’ and facilitated screenings through New England. Each of our representatives is planning activities in the areas they cover. We’ll continue to participate in the celebrations that have become part of our tradition as well as undertake some new approaches to broaden the circle of recovery awareness. Recovery Month is an important activity in many parts of our country, which was evident in the Recovery Planning Partners meeting where I met you. It is important work that we fully support.

April/June 2015

Copyright © 2015 International Nurses Society on Addictions. Unauthorized reproduction of this article is prohibited.

An Interview With Lisa Clark, MSN.

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