A RED NOSES Healthcare Partnership Evaluation

23.February 2022

A RED NOSES Healthcare Partnership Evaluation

The RED NOSES Healthcare Programme Evaluation aimed to generate learning on how to strengthen healthcare clowning partnerships across the RED NOSES network in 11 countries in Europe and the Middle East.

The evaluation examines how RED NOSES offices in different countries have developed and sustained relationships with healthcare institutions, as well as how these partnerships are perceived by hospital staff and leadership.

Read and download the full evaluation here

The evaluation was conducted from June to November 2021 and included the following methods:

  • Survey of random sample of wards:  received 729 responses from 42 hospitals in 10 countries
  • Case studies of successful partnerships: Germany and Jordan
  • 2 focus group discussions with the international working group
  • 7 interviews with experts on healthcare clowning partnerships (4 internal, 3 external)

Healthcare Staff Perspectives

For the healthcare staff survey, a series of impact statements were developed based on the evaluation questions, the RED NOSES Framework of Change, and previous surveys from healthcare clowning organisations. The graphic below shows a summary of the responses.

Positive results – with room to grow

  • Hospital staff showed the highest level of agreement with the statement, “As a result of clown visits, the general atmosphere in my unit improves” and the lowest level of agreement with that statement “As a result of clown visits, I work better with other healthcare staff.”
  • In a further analysis, it was found that respondents who had been trained in humour in healthcare and respondents aged 45 and older were more likely to agree with the statements.
  • No statistically significant difference was found according to the respondents’ profession (nurse or doctor), leadership status (team leader or frontline staff), or frequency of clown visits on their unit.

Hospital staff were also asked about the current role of clowns on the healthcare team, as well as their expectations for the role of clowning in the future.

Their responses are below:

Exploring Partnerships

Based on the qualitative research conducted for this evaluation, a Partnership Compass was developed to provide a shared language and common understanding of what makes healthcare partnerships successful.

The Partnership Compass includes factors that are directly influenced by RED NOSES as well as external and contextual influences. The resulting tool is intended to support programme staff in assessing and strengthening partnerships over time.

The key themes explored in the Partnership Compass are:

  • Shared Goals: A shared understanding of the clown’s role in the healthcare system, as well as support from top-level and unit leadership
  • Service Quality: Clowns’ experience in the healthcare system, as well as how they work together and have opportunities for learning and improvement
  • Education: Training for healthcare workers on humour in healthcare, as well as the availability and understanding of evidence on the impact of healthcare clowning
  • Feedback: The flow of feedback informally in real-time, as well as through more structured and formal methods
  • Collaboration: How healthcare partners prepare for the daily work of healthcare clowning, the extent to which shared workplanning occurs, and how partners participate in co-design of artistic formats
  • Contribution: Partners’ willingness to contribute to healthcare clowning through financial and non-financial means, as well as their participation in fundraising, advocacy, and public relations activities

Read and download the full evaluation here