Enhancing teamwork for safer surgery: Introducing Team CLEFT

Team CLEFT is a new workshop designed for nurses, anesthesia providers and surgeons which supports Cleft teams to learn together.

What is Team CLEFT and how will it make surgery safer for children with cleft?

Team CLEFT is a new workshop designed for nurses, anesthesia providers and surgeons which supports Cleft teams to learn together.

“Team CLEFT training improves skills, knowledge, and professional relationships. That is, it helps professionals to develop their critical thinking and leadership skills, and it also promotes strong case management in cases where an incident has occurred.”
Belinda Karimi, clinical nurse, Mombasa, Kenya, and Team CLEFT trainer.

Developed by the Smile Train-Lifebox Safer Surgery and Anesthesia Initiative, the workshop targets the three main professional groups – anesthesia providers, nurses, and surgeons –   who collaborate together as ‘Cleft teams’ to deliver cleft surgery and care in the operating room and post-operative recovery areas. 

The workshop focuses on improving teamwork and communication processes during emergency events, as well as routine best practices for surgical safety. Participants are supported by faculty to tackle challenging clinical scenarios together in a safe and respectful environment. Cleft teams from different facilities train together to learn team-to-team and across disciplines – encouraging the sharing of best practices and helping build a network of practitioners for cleft care.  This workshop is particularly important since children with cleft are at higher-risk of complications during surgery.

“Cleft surgery is a good reflection of a team approach in management of these patients and a strong team service can result in the best outcome for a patient. The training increases the team capacity and cohesion of nurses, anesthesia providers and surgeons, improving their knowledge and implementation of safety processes to reduce the risk occurrence during cleft surgeries and improving their ability to deal with and manage emergency situations effectively as a team when they do occur.”
Dr. Tihitena Negussie, pediatric surgeon, Tikur Anbessa Hospital, Ethiopia, and Lifebox Global Clinical Director

Team CLEFT has so far been piloted in Ethiopia, Uganda and Kenya by national faculty teams. In total, 55 multidisciplinary clinicians have completed the course from 11 hospitals, with six clinicians trained-as-trainers. 79% of participants* who took part said they were extremely likely to recommend this course to a colleague.

Team CLEFT is delivered with a focus on interactive and practical learning experiences which challenge hierarchical and communication barriers within surgical teams. Teaching methods include short lectures, role-play, clinical scenarios, team-building exercises, reflection on practice, and action planning for change. 

Team CLEFT workshop participant feedback: 

“I appreciate these types of inclusive or multidisciplinary training to improve quality service…finally we can decrease mortality and morbidity of patients.”

“The practical part of the course gives an opportunity to see the openness of people without looking at the hierarchy, also I enjoyed sharing ideas and experience from different hospital settings.”

“Keep it up, I really appreciate these training sessions. If we can do it together, we can change the world.”

Team CLEFT was developed as part of the Smile Train-Lifebox Safer Surgery and Anesthesia Initiative, a multi-year strategic partnership to elevate the quality and safety of cleft and pediatric surgery in more than 70 countries. Through capacity building, innovations, and research, the Initiative aims to strengthen the surgical systems of over 1,000 hospitals around the world.


“Team CLEFT is a very important training as teamwork is an essential part of cleft care, not only intraoperatively but even beyond the perioperative period, as these children require multidisciplinary care. This program will ultimately result in safer cleft surgery with better outcomes.”
Dr. Samuel Negash, pediatric surgeon, assistant professor of surgery, Wolkite University Hospital, Ethiopia, and Lifebox Senior Fellow.