Manage and measure: Reducing natural gas and waste leads to less GHG emissions

Ascension, United States

Case study summary

Ascension’s commitment to reducing its environmental footprint and achieving sustainability is rooted in their mission, which calls them to advocate for a compassionate and just society in their actions and words. A comprehensive inventory of carbon emission data in 2020 provided the insights needed to reach milestones in their Race to Zero. Reducing waste and natural gas through innovative strategies have contributed to carbon reduction goals while saving valuable MMBTUs.

Demographic information

  • City: St. Louis
  • State/province/region: Missouri
  • Country: United States
  • Type of institution: Health system
  • Number of full-time staff: 139,000
  • Number of beds: 25,000 (FY22 stat)
  • Patient population served annually 
    • 6.5+ million patients served annually (inpatient and outpatient FY22 stat)
    • Geographic area served: 19 states (Alabama, Arizona, Arkansas, Florida, Georgia, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, New York, Oklahoma, Tennessee, Texas, Wisconsin).
    • Health equity concerns experienced by your population: access to care, mental and behavioral health, food insecurity/obesity
Ascension's solar panels at Dell Children's Medical Center

The issue

Climate impacts affect regions Ascension serves, such as Nashville, Tenn., which has experienced more intense rain events. Increased air pollution and allergens aggravate respiratory diseases, asthma, and cardiopulmonary disease. As climate-related events become more common, impacts on health and health care will increase in frequency and intensity. Vulnerable populations such as children, pregnant women, older adults, and people with low incomes face increased risks. Ascension is reducing its carbon footprint to improve air quality and support healthier communities.

Hospital goals

Ascension committed to Race to Zero, the U.S. Department of Health and Human Services Health Sector Climate Pledge, and the Laudato Si Action Platform.

  • 2030: Reduce carbon emissions 50%; reduce 50% of nonhazardous waste from all sites.
  • 2040: Achieve net zero carbon emissions and zero waste across all sites.

Sustainability strategy implemented

Ascension set its energy efficiency baseline in 2008, then began an environmental stewardship program in 2011. After joining the U.S. Department of Energy’s Better Buildings Challenge in 2012, the goal was met in 2017 with a 23% energy use reduction.

In 2020, Ascension held a strategic planning exercise for the sustainability program. This concluded on Earth Day 2021 with the launch of its environmental impact and sustainability program. The program maximizes environmental impact with activities in three pillars: net zero places, responsible supply chain, and healthy communities.

Implementation process

The program builds upon Ascension’s existing efforts in energy efficiency, waste management, and environmentally preferred purchasing. The healthy communities pillar supports the well-being of patients, associates, and communities served. 

Ascension implemented steps to achieve its carbon reduction goals. By doing so, the system overcame challenges associated with moving from energy efficiency tracking to carbon reporting. Tasks included:

  • Adding a sustainability director with carbon reporting experience and an analyst to manage the data. As sustainability directly aligns with Ascension’s mission, the sustainability organization structure and related positions were approved at the executive level, along with funding to fill positions needed to successfully implement external and internal commitments to sustainability. 
  • Collecting new data sources across the organization (vehicles, anesthetic gasses, refrigerants).
  • Ensuring data was valid, accurate, and comprehensive. 
  • Engaging an external consultant to work with the new team and establish a reporting methodology to manage internally.
  • Maintaining consistent management of assumptions, such as emissions factors.

Ascension associates play a role in achieving these goals. For example, facility-based green teams help reduce carbon emissions by asking facilities managers if a site is engaged with the steam trap program.

Tracking progress

Ascension submitted 2019 Scope 1 and 2 data to Race to Zero via Health Care Climate Challenge’s platform. Ascension will submit 2020 through 2022 data later in 2023. In FY23, the sourcing workgroup assessed GHG emissions of 61 suppliers using Carbon Disclosure Project data. Forty vendors were added to a Scope 3 emissions dashboard.

Ascension is reducing its carbon footprint to improve air quality and counteract the health impacts of climate change affecting those served particularly vulnerable communities. Examples of poor air quality occurred in 2023 from record heat in Texas and wildfire smoke drifting from Canada to Chicago.

Progress achieved

Ascension is lowering air pollution in the regions the health system serves to help sustain the health of communities. Examples of progress achieved include:

  • Submitted baseline carbon emissions data in 2022 as part of the commitment to Race to Zero. 
  • Achieved two FY23 goals: reduced GHG emissions by 5% from an FY20 baseline, and reduced municipal solid waste sent to the landfill by 6% from a FY19 baseline.
  • Completed green energy supply agreements in the Midwest.
  • Received national awards for 27 sites of care for outstanding sustainability performance in FY23 alone.
  • Saved 70,600 MMBTU since FY22 due to Ascension’s steam trap replacement program. Replacing this part results in less natural gas needed to meet heating loads, directly contributing to carbon reduction goals.

Challenges and lessons learned

Ascension’s environmental impact and sustainability team learned valuable lessons while overcoming carbon reporting challenges, including:

  • Ensuring access to and quality of data.
  • Calculation methodology and remaining up to date with regulatory changes and innovation.
  • Future regulatory impacts from the U.S. Securities and Exchange Commission and the Joint Commission.
  • Managing local regulations in Chicago, Austin, Baltimore, and Washington, D.C.
  • The need to be flexible in the short term while remaining focused on long-term goals.
Ascension_Green Roof at St Elizabeth Appleton

Next steps

Next carbon reporting steps for Ascension:

  • Develop science-aligned goals to achieve 2030 commitments.
  • Break goals into two three-year phases to make them actionable:
    • FY24-26, FY27-29, and six months before CY2030.

Carbon reporting will continue through the net zero places pillar of the environmental impact and sustainability program. This pillar focuses on carbon sources associated with physical environments, such as energy and water management and mobility.