JoAnn Harrold

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JoAnn Harrold
Division Head, Newborn Care Department of Obstetrics and Division Head, Newborn Care Department of Obstetrics, Gynecology and Newborn Care Division Chief

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Biography

Dr. Harrold completed medical school at McMaster University, pediatrics residency at University of Toronto and Neonatal-Perinatal Medicine subspecialty training at McMaster University. She has been on staff at CHEO and TOH since 2002 as a neonatologist and has been Division Head since 2015. She is also the Newborn Lead for the Champlain Maternal Newborn Regional Program and extensively involved with BORN Ontario.

Patient Care Philosophy

I provide excellent, comprehensive, patient and family-centered care. My main role model for excellence in clinical care is one of the supervisors I had during my training in Neonatal-Perinatal Medicine. I learned from her the value of a strong work ethic, the importance of attention to detail and how to hold oneself to a very high standard while being compassionate with families and a part of an inter-professional team rather than a solitary force. I find myself reflecting on her and her practice often, and in many respects, have bolded my practice after what I learned from her.

My patients represent a vulnerable population. They include the smallest infants born at the edge of viability and newborns with very complex congenital anomalies or multi-system medical issues. None of my patients are able to provide the details of their symptoms which most other physicians rely on as a starting point for care. My attention to detail, experience, training, intuition and ability to listen to parents and the other members of the team help me to put the pieces of the puzzle together correctly and rapidly to provide excellent care for my patients.

During rounds, and throughout the day, I listen carefully to what others on the team tell me about the patients and their interpretation of what they are seeing. I pride myself on the fact that I have repeatedly been commended for considering the views of others and truly respecting their input.

I believe that every patient is an individual and that available evidence and local guidelines should be applied in the context of that individual. I believe that clinicians should never blindly apply an algorithm to a patient because “that is what we do” but should critically evaluate whether the patient fits the algorithm or requires more personalized care. I am recognized by residents and fellows for training them this way and instilling in them the importance of critical thinking and the correct application of guidelines versus fully individualized care when appropriate.

In neonatology, the death of a patient is not rare. I feel strongly that it is part of my role to assist the family in preparing for the death of their child and in making the experience as meaningful and personal for them as possible as this is often a lasting memory for the family. I have often been told by nurses and social workers that I am extremely compassionate and clear when communicating bad news to parents. Additionally, I have had families, even during the time of crisis, tell me how much they value and appreciate my support and the time I have spent with them. I consider the manner in which I communicate with and support families during the time surrounding the death of their baby as personal strengths.

Selected Publications

  • Harrison D, Reszel J, Wilding J, Abdulla K, Bueno M, Campbell-Yeo M, Harrold J, Nicholls S, Squires J, Stevens B. Neonatal pain management practices during heel lance and venipuncture in Ontario, Canada. Newborn and Infant Nursing Reviews 2015; 15:116-123.
  • Poets CF, Roberts RS, Schmidt B, Whyte RK, Asztalos EV, Bader D, Bairam A, Moddemann D, Peliowski A, Rabi Y, Solimano A, Nelson H; Canadian Oxygen Trial Investigators. Association Between Intermittent Hypoxemia or Bradycardia and Late Death or Disability in Extremely Preterm Infants. JAMA. 2015 Aug 11;314(6):595-603. doi: 10.1001/jama.2015.8841
  • Wang D, Aubertin C, Barrowman N, Moreau K, Dunn S, Harrold J. Reduction of noise in the neonatal intensive care unit using sound-activated noise meters. Arch Dis Child Fetal Neonatal Ed 2014 Nov;99:F515-F516.
  • Schmidt B, Roberts RS, Whyte RK, Asztalos EV, Poets C, Rabi Y, Solimano A, Nelson H; Canadian Oxygen Trial Group. Impact of study oximeter masking algorithm on titration of oxygen therapy in the Canadian oxygen trial. J Pediatr. 2014 Oct;165(4):666-71.e2.
  • Wang D, Aubertin C, Barrowman N, Moreau K, Dunn S, Harrold J. Examining the Effects of a Targeted Noise Reduction Program in a Neonatal Intensive Care Unit. Arch Dis Child Fetal Neonatal Ed. 2014 May;99(3):F203-8. doi: 10.1136/archdischild-2013- 304928. Epub 2013 Dec 19.
  • Schmidt B, Whyte RK, Asztalos EV, Moddemann D, Poets C, Rabi Y, Solimano A, Roberts RS; Canadian Oxygen Trial (COT) Group. Effects of targeting higher vs lower arterial oxygen saturations on death or disability in extremely preterm infants: a randomized clinical trial. JAMA 2013 May 22;309(20):2111-20.

Fields of Interest

  • BORN BIS
  • Infant pain prevention
  • Use of Emergency Departments by infants in the first month of life
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