Global medical mission trips have become a prevalent practice for physicians seeking to provide orthopaedic surgical care to underserved populations around the world. This type of volunteer work has played an important role in providing both acute disaster response and long-term basic medical care for the affected populations 1 . Over time, what was meant to be a temporary solution has resulted in international charitable organizations becoming permanent providers of medical and surgical care 2 . The development of best practices surrounding international mission work has been advanced by medical associations and nonprofit organizations 3,4 . Challenges in the global health setting include a lack of access to specialized orthopaedic expertise and facilities, a lack of access to high-quality implants, logistical challenges (e.g., medical record-keeping limitations), and safety issues due to war or natural disasters [5][6][7] . FAJR Scientific ("FAJR"), a nonprofit organization, has recently published findings from its first orthopaedic medical mission trip, during which it was faced with many of these challenges, which made it difficult to attain its mission goals 8 .On its second mission trip, FAJR developed a systematic approach with use of the Six Sigma quality control principles to optimize future missions. By applying these principles, FAJR met and surpassed its mission goals, including the completion of 153 complex lower-extremity orthopaedic cases in challenging conditions over a period of 5 days. The FAJR team was composed of 32 carefully selected medical professionals, including surgeons, residents, anesthesiologists, nurses, and physical therapists. Additionally, the FAJR team educated and trained over 43 orthopaedic residents, 55 operating and circulating room nurses, 34 anesthesiologists, 28 floor nurses, 12 physical therapists, and 90 researchers to manage and maintain a newly developed electronic medical record (EMR) that was created to meet the unique needs of the host country. Furthermore, FAJR provided education to orthopaedic attending physicians on adopting advanced surgical principles and implementing accepted guidelines for perioperative management. In this article, we introduce the "FAJR methodology" as a standardized method for performing high-quality global orthopaedic mission trips. This novel approach is based on quality assurance principles that provide a comprehensive and standardized approach to subspecialized orthopaedic surgical care in underserved settings.
MethodologyFAJR completed its first mission in the West Bank, Palestine, in January 2023; we performed 48 surgeries, including hip and *A list of the FAJR Scientific Research Collaborative members is provided in a Note at the end of the article.
