**2. Multidisciplinary team building**

A multidisciplinary team of qualified healthcare professionals is the foundation to achieve proper cleft care anywhere in the world, as the management of orofacial cleft requires expertise from providers in various fields of medicine and dentistry.

Given the complexity and life-threatening risks inherent in performing surgical procedures, it is crucial that all team members be highly skilled and well trained in the patient care of cleft anomalies. The educational and experience requirements of each specialist on the cleft team are determined by individual specialty board, various professional associations, state licensing board, etc. These requirements change over time. The professional members should be encouraged to stay updated on all the current teachings in their respective fields by actively participating in continuing educational activities and attending professional meetings. This not only ensures that they possess appropriate and current credentials but also have the requisite experience in evaluation and treatment of patients with craniofacial anomalies [1, 7, 10].

For this purpose, large and fully articulated cleft care teams must be designed to deliver an entire range of care to the patients. This is essential in building long-term, sustainable, and selfsufficient cleft care centers. Such a team should include the following members [6, 7, 14–16]:

**1.** Pediatrician

economic and psychosocial burden on the individual and the families involved. The burden of care for children with orofacial clefts in LMIC is disproportionally immense due to the severely limited access to basic care. People in these resource-limited regions regularly live with untreated clefts their entire lives, battling with prejudice and social ostracism [6]. A large number of humanitarian cleft care missions have provided corrective treatments to patients in LMIC who would not otherwise have had access to such care. However, it remains difficult to provide global care to these patients due to a number of obstacles, including security issues, logistical obstruction, lack of reliable social service facilities, unsustainable or short-lived local

Until recently, there had not been a set of commonly accepted standards for cleft care in less developed countries. Aiming to fill this gap, in 2006, the Volunteers in Plastic Surgery Committee of the American Society of Plastic Surgeons/Plastic Surgery Educational Foundation undertook the project of creating universal guidelines to improve quality and safety for providing reconstructive plastic surgeries in developing countries. Experienced international cleft surgeons along with representatives from Society for Pediatric Anesthesia created and published a set of guidelines, and the final document has been reviewed and approved by the boards of both organizations [8]. During the same year, Operation Smile, the largest American international cleft organization, independently convened its own conference of experts from each specialty around the world to ensure that every child receives the same first world standard of care in an international mission. The product of the conference was "Operation Smile's Global Standards of Care," which was adopted by over 60 member countries within Operation Smile network [9]. Both documents included comprehensive outlines for each aspect of cleft treatment, including site preparation, team make up, equipment, logistics and traveling, and safety standards so that every cleft child and their family can expect the same level of quality care no matter where they live [8, 9]. They have also provided foundation to the new paradigm of international cleft care, which is the creation of free-standing, sustainable cleft centers around the world, staffed, and operated year-round by both local

This chapter will briefly focus on the strategies that can help optimize global standards for cleft care, which should be followed when planning a cleft mission or building a selfsufficient cleft care facility to provide optimal and longitudinal care to patients with cra-

A multidisciplinary team of qualified healthcare professionals is the foundation to achieve proper cleft care anywhere in the world, as the management of orofacial cleft requires exper-

Given the complexity and life-threatening risks inherent in performing surgical procedures, it is crucial that all team members be highly skilled and well trained in the patient care of cleft anomalies. The educational and experience requirements of each specialist on the cleft team

cleft care centers, less qualified local personnel, and long-term follow-up [7].

and international personnel [10–13].

44 Designing Strategies for Cleft Lip and Palate Care

**2. Multidisciplinary team building**

tise from providers in various fields of medicine and dentistry.

niofacial anomalies.


If a cleft care center recruits international professionals once or twice a year during special cleft surgery camps and cleft missions, the presence of a skilled translator also becomes important because language barrier can hinder full team performance and potential. Therefore, qualified interpreters should be provided to ensure proper verbal and written communication among the team members, patients, and families. The team needs to work in a coordinated manner to provide appropriate care to any patient that comes with a cleft anomaly [10, 17].

Some cleft care centers are not able to provide all types of examinations and services required by the patients. The team in such facilities should have a mechanism for referral to the required professionals, who will be able to provide the necessary service to the patient [11].

Lastly, it is important that all members of the team are monitored regularly and their performance reviews are maintained, so that the quality of care provided to the patients is not compromised.
