Reducing Aggression towards Emergency Room Staff with Clown Care: An Intervention Study
Humor and laughter are well-known promoters of stress relief, interpersonal communication, and effective social networking. Extensive research has shown that this holds true in hospital environments as well, as evidenced by the widespread employment of medical clowns in hospital departments the world over. Clown care has been shown to alleviate pain, anxiety and stress among hospital patients of all ages—infants, children and adults—as well as facilitate and improve staff-patient communication. Medical clowning aims to foster the emotional and physical well-being of hospitalized patients, creating a unique experience that moderates the patient's immediate environment and improves their ability to handle pain, illness, and life-threatening conditions.
The past decade has seen a continued increase in aggressive behavior towards medical staff in Israel. Israel's Ministry of Health formed a committee for the elimination of violence against staff in the health system, published educational software on the prevention of violence, acknowledged the need for additional security measures in hospitals and medical centers, and promoted awareness of the issue among health system employees and the general public. These measures, while considerable, have not succeeded in eliminating the problem as more and more violent incidents targeting medical staff continue to occur, especially in emergency rooms during the hours of the late evening and night. Some prove fatal.
To combat the increase in aggressive behaviour towards medical staff, a group of professional leaders from the Shamir Medical Center (Assaf Harofeh) formed a joint workgroup with the Dream Doctors Project non-profit orgazation, Israel's first and largest medical clowning program. Together, Ms. Gila Lavi, head of the Shamir Medical Center medical clowning program, Dr. Efrat Danino, head of the center's Academic Nursing School, Dr. Osnat Levtzion-Korach, general director of the Shamir Medical Center, and Mr. Tsour Shriqui, Executive Director of the Dream Doctors program, initiated a unique intervention study to research the effectiveness of medical clowning in reducing physical and verbal aggression towards hospital staff. The research measured the impact of clown care on aggressive behaviour towards Emergency Room staff, specifically during the late hours of the evening and at night, when the majority of violent incidents occur.
The intervention study began with measuring the frequency and type of aggressive incidents in the Emergency Room without the presence of medical clowns. A group of medical clowns, specifically trained to work in emergency rooms with adult patients, were then integrated into the Shamir Medical Center's Emergency Room during the evening and night shifts on an on-going basis. After six months, the researchers measured the occurrence of aggressive behaviour while clown care was implemented and found that it was significantly lower:
- Verbal aggression was reduced by 75%
- Physical violence was reduced by approximately 43%
- The overall occurrence of aggressive behaviour was reduced by 47.8%
Clearly, the presence of medical clowns deterred aggressive behaviour towards medical staff and fostered a positive and calm atmosphere among patients, attendants and staff.
In conjunction with other processes, medical clowning can help reduce violence towards medical and administrative hospital staff. If its benefits are to be reaped, the necessary resources would have to be invested in the routine implementation of clown care in emergency rooms, particularly during the times when violence towards staff members is at its peak.
New Research
The Effect of Medical Clowning on Aggressive Behaviour Towards Hospital Staff
Recent years have seen an increase in aggressive behaviour towards medical staff, especially in emergency rooms during the late hours of the evening and night. A new research, headed by Ms Gila Lavi, head of the Shamir Medical Center’s medical clowning program, Dr. Efrat Danino, head of the center's Academic Nursing School, Dr. Osnat Levtzion-Korach, general director of the Shamir Medical Center, and in collaboration with Mr. Tsour Shriqui, Executive Director of the Dream Doctors program, Israel's first and largest medical clowning program, found that the presence of medical clowns deterred aggressive behaviour towards medical staff and fostered a positive and calm atmosphere among patients, attendants and staff.