Our new address is:
H.H. Angus and Associates Limited
1176 Eglinton Avenue East
Suite 800
Toronto, ON M3C 0S1
All other contact information remains the same.
We invite all of our clients to drop by for visit anytime you are in the neighbourhood.
HH Angus Digital Services is pleased to announce our graduation with the AWS Partner Acceleration Team. Over the past several months, we worked with AWS Partner Management resources to achieve Select Tier Status, joined the AWS Public Sector Program, and achieve technical differentiation through a Foundational Technical Review of both our ARMS Platform and our AWS Cloud Consulting service offering. Working with this team helped us to accelerate our AWS journey and continue to build out our AWS cloud practice to deliver our ARMS platform. ARMS is focused on asset management and our Cloud Consulting service offering is focused on IoT and Smart Buildings Implementation for public and private sector customers.
To learn more about our ARMS platform, click here:
Angus Remote Management Systems (ARMS) – H.H. Angus and Associates Ltd. (hhangus.com)
In recent years, we’ve seen growing interest from clients in pushing their buildings forward from being “digitally-enabled” to “smart.” Smart buildings promise a host of benefits, such as better user experiences, enhanced operational efficiency, and improved security and safety. And while there have been many advances in technology systems to simplify this transition, the most effective path to a smart building is through integration.
Integration refers to the seamless connectivity and interoperation of various technology systems within a building. It can produce a wide variety of results, whether it’s opening a door, displaying information on a dashboard, or sending a notification to the correct person that a visitor has arrived for a meeting. The challenge for facility owners and operators lies in identifying which integrations will deliver the most substantial impact and what functionality will users truly value. Integrating systems comes at a cost – these may include physical connections, additional licencing fees, or even new staff. How can you know which integrations will have the greatest return on investment (ROI)? What process would building occupants like to see simplified? To navigate these complexities, an integration consultant can help companies develop a comprehensive strategy.
An integration strategy establishes clear objectives that align with the organization’s overall vision, goals, and design assumptions. At the outset, it is crucial to determine the organization’s most important objective; for example, is it security, efficiency, or user experience. A company that prioritizes security will focus on integrating systems that enhance building safety and protect data integrity. On the other hand, an organization emphasizing user experience will seek integrations that streamline operations and improve comfort for building occupants.
It's also important to understand an organization’s constraints. Integration systems can significantly change an existing workflow - making IT support, change management and operational readiness important considerations to ensure a successful shift towards a smart building environment.
A well-crafted integration strategy ensures consistency and standardization for system integration requirements, both now and in future. By looking at integration holistically, organizations can minimize costs and maximize ROI. Standardization helps in maintaining compatibility across different systems, which in turn reduces the risk of integration failures and ensures smooth operation. This approach also helps future-proof the building, making it easier to incorporate new technologies.
An integration strategy provides an actionable implementation plan. This plan guides organizations and vendors through the complexities of implementation projects, helping to manage unforeseen challenges and mitigate risks. An effective strategy identifies coordination issues, planning gaps, and requirements for commissioning, training, and support early on. This proactive approach ensures that all stakeholders are aligned and prepared to handle challenges that may arise during the implementation phase.
Integration consultants play a crucial role in this process. We bring a wealth of expertise in identifying the most impactful integrations and understanding what end-users value most. Our experiences and insights help us craft strategies that not only align with your organizational goals but also address the practical realities of implementing system integrations in buildings.
As buildings become increasingly complex, integration represents the next step in their evolution from digital to smart. By establishing clear objectives, ensuring consistency and standardization, and providing actionable implementation plans, organizations can unlock the full potential of their technology investments. This holistic approach to integration is not just about adding new systems; it's about creating a seamless, efficient, and future-ready environment that meets the needs of all stakeholders.
For find out how an integration strategy can help your building’s technology transition, contact us at connectconsulting@hhangus.com.
Several of HH Angus’ senior healthcare experts will be presenting at this year’s Canadian Healthcare Engineering Society’s national conference. The conference starts on September 8 at the Halifax Conference Centre, and our staff will be speaking on Tuesday September 10 at the following sessions:
Julie Lawson and Preethi Sethi take attendees through a ‘day-in-the-life’ inpatient journey characterized by a prolonged medical stay, and highlight challenges and opportunities for improvements with the application of technology systems and management of the environment. Their topics include:
Julie Lawson, P.Eng., LEED AP
Manager, Senior Mechanical Engineer
Associate | Health Division
Preethi Sethi, MSc. eHealth, DMS, CRGS ICAT Consultant, Angus Connect Division
The Canadian Standards Association’s new edition of CSA Z317.2 Special Requirements for HVAC Systems in Health Care Facilities was published in June 2024. Nick Stark identifies some of the considerable number of new and revised clauses impacting requirements for design, construction and operation of healthcare facilities across Canada. Nick will identify potential impacts of the changes and the different approaches to HVAC that will be required in future.
Nick Stark, P.Eng, CED, LEED®
AP, ICD.D,
Principal, Executive Vice President
Meagan Webb and Ryan Kennedy, together with Kyle Basilius of Parkin Architects and Calvin Winquist from Island Health are presenting the plenary session – a spotlight on the Cowichan District Hospital project in Duncan BC, which is being delivered through the Alliance Procurement Model. The presentation will focus on the project goals of relationship building, net-zero carbon future, and healing environment, and how these are being delivered with the hopes of giving back to the people and lands the project will serve, as well as how the Alliance Procurement Model has been leveraged to achieve these objectives.
Meagan Webb, P.Eng
Regional Leader, Principal
HH Angus and Associates
Ryan Kennedy, P.Eng., LEED AP BD+C
Technical Leader, Principal
HH Angus and Associates
Kyle Basilius, AIA, ACHA, EDAC, NCARB Principal,
Parkin Architects
Calvin Winquist
Director Design and Construction
Island Health
Historically, N2O has been used in healthcare facilities (“HCF”) for anesthetic and/or analgesic purposes:
(1) Anesthetic use has often been as the “carriergas” for delivery of vaporized anesthetic agents (Sevoflurane, Isoflurane and Desflurane as examples) to a patient using a breathing circuit and undergoing general anesthesia, (2) Analgesic use has traditionally been for pain management and can be clinician- or patient administered (for example, by expectant mothers breathing N2O to reduce pain associated with contractions). Typically, it does not require the use of a breathing circuit (anesthetic machine) as the patient will be conscious while directly expelling the N2O into the room instead of into a breathing circuit. While N2O continues to have clinical application, there has been a significant shift to reduce its use, particularly in surgical settings, in favour of more environmentally-friendly anesthesia techniques.
As HCF’s continue to grapple with reducing emissions, N2O has again come under the spotlight. In the US, the healthcare sector is responsible for an estimated 8.5% of US greenhouse gas emissions(1). Further, medical gases contribute up to 40% of hospitals’ direct emissions(2), with N2O pipeline leakage alone contributing upwards of 90% of the N2O consumption when measured against actual clinical consumption use. It has been known for some time that most centrally piped N2O pipeline leakage occurs through the plastic hoses used in ceiling arms (aka booms, articulating arms, ceiling pendants) that can move vertically and horizontally, as well as the plastic hoses supplied with equipment that connect to a terminal unit (outlet). N2O is known to permeate these plastic hoses. The leakage of N2O through the plastic hose is typically across its entire length. Teflon pigtails used to connect nitrous oxide cylinders to a cylinder manifold have also been found to leak, but the CSA Z7396.1 standard banned the use of polymer-lined flexible metallic pigtails for pressure gases in favor of copper pigtails.
Studies have reported adverse health effects for workers exposed to N2O. These include reduced fertility, spontaneous abortion, and neurological, renal and liver disease(1). Patient and clinical staff health effects can also include nausea and vomiting(1). There have been studies on acute and chronic exposure to individuals or groups inside a HCF(4). The results indicate a significant difference in health effects for groups exposed to N2O which include headaches, dizziness, nausea, vomiting, euphoria and tachycardia (heart rate > 100 bpm).
In 2024, the Canadian Anesthesiologists’ Society (CAS) issued their revised edition of Guidelines to the Practice of Anesthesia.(5) In this guideline, Section 10 (page 31 Guidelines for Environmental Sustainability), indicates the following points with regard to N2O:
“The use of desflurane and N2O should be eliminated or minimized to the extent possible given local resources, locations, and the clinical context.”
“Environmentally-friendlier anesthesia techniques such as neuraxial/regional anesthesia and total intravenous anesthesia may be considered as alternatives to volatile inhalational anesthesia to minimize greenhouse gas burden when clinically appropriate, feasible, and available.”
On April 25, 2024, the AAQ(3) issued the following statement: AAQ aposition statement on N2O pipelines The Association des anesthésiologistes du Québec Board of Directors, representing the largest traditional users of medical N2O, has unanimously taken a position on N2O pipelines in hospitals on April 25:
“The AAQ supports decommissioning central N2O pipelines in existing hospitals, no longer installing them in new hospitals, and, if necessary, working with N2O cylinders.”
Furthermore, the elimination or minimization of N2O from anesthetic practice has been a recommendation of the Canadian Anesthesiologists’ Society’s Guidelines to the practice of anesthesia since 2023.
Given the opinions from the CAS and AAQ to pivot away from using N2O in favour of other friendlier anesthesia techniques, and coupled with the known leakage concerns from centrally piped N2O pipeline systems, an opportunity exists for HCF’s to reevaluate with their anesthesiology department stakeholders the clinical use of N2O and the delivery method. Reevaluating N2O usage and delivery methods also aligns with Annex P recommendations in CSA Z7396.1 medical gas standard.
HH Angus cannot provide any opinion on the clinical use of N2O as this is a medical issue. This client advisory serves only to highlight recent opinions and studies on known problems associated with the leakage of N2O from centrally piped medical gas pipeline systems, as well as the recommendations from the CAS and AAQ. The HCF must make its own determination on the suitability of continued clinical use of N2O and the associated delivery methods.
1. Decommissioning N20 Playbook - WORKING VERSION.docx (practicegreenhealth.org).
2. Collaborating to prevent nitrous oxide waste in medical gas systems_FINAL 5-2-2023.pdf (practicegreenhealth.org)
3. https://mcusercontent.com/195cedfbb43cfc829ac342437/files/d239380c-8484-d56a-92b4-c50f920bd63a/Prise_de_position_AAQ_N2O.03.pdf
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5661723/
5. https://www.cas.ca/CASAssets/Documents/Practice-Resources/Guidelines/CAS_Final_Guidelines_2024.pdf
Edward Hood, P.Eng.
Principal | Engineering Director, Health
Edward.Hood@hhangus.com