NAFHCO aims to advance the field of healthcare clowning by establishing and maintaining professional standards, enhancing the professional growth and development of members, thereby advancing the credibility of the healthcare clown profession. The excitement and buzz about this gathering led the two organizations to seek out and invite representatives from other healthcare clowning organizations
in North America. The gathering was such a success that it helped catapult the creation of the North American Federation of Healthcare Clowning Organizations (NAFHCO). In January 2019, we hosted the second “Meeting of the Noses” in Atlanta, Georgia. At this conference, 42 clowns representing nine organizations came together for a hands-on workshop and discussion of how to take healthcare clowning into the future. There was great focus on training and research development, and a push to create an accepted standard for this work in North America. In 2019, we began the process of vetting each of the founding organization using a rubric developed to rate each member organization’s artistic, financial and organizational fitness for NAFHCO. For our conference in 2020 in Dallas (just before COVID-19), sixty clowns representing over a dozen organizations from the United States and Canada came together again for a conference focusing not only on artistry, but also on diversity, equity, and inclusion, and how healthcare clowns can be on the forefront of this very important work. In 2021, we plan to go virtual with our next conference.