Development of Literacy-Friendly Discharge Instructions for Patients With Cleft Lip and/or Palate

Postoperative care following cleft surgery requires caregivers to follow multiple recommendations related to feeding, wound care, medications, oral hygiene, activity restrictions, and recognition of warning signs. In low-resource settings, differences in health literacy and availability of recommended supplies may further complicate postoperative care. Global Smile Foundation (GSF) identified variability and text-heavy content in existing discharge instructions, resulting in inconsistent recommendations among providers and caregiver confusion. The authors developed standardized, literacy-friendly discharge instructions for use across GSF cleft care programs in Ecuador, El Salvador, Lebanon, and Peru. A multidisciplinary team of surgeons, pediatricians, nutrition specialists, speech-language pathologists, nurse practitioners, and dentists developed and reviewed the materials. Existing postoperative recommendations were adapted to the local resource and cultural contexts. Patient-facing instructions were designed using simplified language, a fourth-grade reading level, visual aids, color-coded elements, and translations into Spanish and Arabic. Materials were developed for 4 procedures: cleft lip repair, cleft palate repair, premaxillary setback with cleft lip repair, and alveolar bone grafting. Provider-facing instructions were also developed to promote consistency in education. Implementation included standardized communication pathways, caregiver teach-back, and provision of procedure-appropriate feeding and wound care supplies. Informal feedback from providers and caregivers suggested improved clarity and consistency in postoperative education. This initiative demonstrates a practical approach to standardizing cleft discharge education through health literacy–informed, visually oriented materials that can be adapted to resource-limited settings. Formal evaluation of comprehension, usability, and clinical outcomes is warranted.