CR4HC Case Study: Ascension

Weathering the Storm: How a Culture of Resilience Prepared Ascension to Withstand Climate Hazards

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New extreme winter weather challenges

In 2021, winter storms Uri and Viola swept through the continental United States, bringing extreme cold weather to the Midwest, Central Plains, and Southern regions. Several states experienced temperatures more than 30°F below normal (Bolinger et al., 2022). 

The polar vortex brought ice and snow to regions of Texas where few mechanisms are in place to clear streets and walkways. Many communities experienced low water pressure when uninsulated pipes burst during sustained freezing temperatures. More than 10 million residents and many businesses lost electricity, some for several days (Busby et al., 2021). Numerous hospitals and healthcare facilities were severely affected, causing them to close their doors and evacuate patients. Overall, the polar vortex resulted in 246 deaths and nearly $130 billion in economic losses from destruction of crops, damage to structures, and loss of life. Throughout this crisis, the Ascension health system continued to care for patients, serve as a refuge for community members, and assist with coordinating response teams.  

Coordinated Surveillance and Response 

The Ascension health system includes 139 hospitals across 19 states and the District of Columbia. Its global operations center uses digital platforms to communicate and coordinate with local communities, health centers, governments, and medical personnel to continuously scan for emergency events that may impact critical services. Informing these activities is a private meteorological service that provides updates for each of Ascension’s registered locations, enabling the operations center to receive accurate and detailed weather warnings up to 48 hours prior to weather events.  

This coordinated, real-time surveillance enabled Ascension to act ahead of the polar vortex. Ascension stockpiled potable water ahead of time and maintained water pressure throughout its buildings using water tankers obtained from construction teams. It not only remained operational throughout the disaster, but also leveraged its relationships with other healthcare organizations to coordinate patient transfers from other area hospitals that needed to evacuate. 

Integrating principles of resilience in emergency management practices

Ascension’s service area has experienced an increase in both the number and severity of extreme weather events, such as damaging winds and heatwaves, as well as changes to the kinds of weather events that each region has historically experienced. Planning for evolving extreme weather patterns in the setting of climate change has become increasingly important. After the polar vortex, the Ascension team updated the organization’s emergency preparedness and response guide to plan for future climate emergencies, in line with the goal of continuously identifying gaps and planning for contingencies.

Ascension creates facility plans and action guides to minimize damage and maximize operability if an extreme event occurs. Ascension incorporates sustainability into its building designs to promote climate resilience, including Dell Children’s Medical Center in Austin, Texas, which earned the country’s first-ever LEED for Healthcare (LEED-HC) Platinum designation (U.S. Department of Energy, n.d.). Sustainable design features include reducing power usage in unoccupied spaces (e.g., lowering lights, adjusting temperature and airflow), and incorporating recycled materials into building designs, preferentially using non-toxic and environmentally sustainable interior materials (Ascension, 2023). 

Ascension seeks to support resilience activities beyond its own facilities. To support community resilience, Ascension seeks to strengthen relationships within its facilities’ local communities. For example, it offers educational programs on emergency preparedness to community members, local health departments, and other healthcare organizations. Health centers and other healthcare and community organizations are incorporated into Ascension’s emergency preparedness and response plans. Community partners offer advice and support during local decision-making processes, including while actively responding to emergencies. Community touchpoints and interactions are not limited to crisis response; they are a regular occurrence that builds trust and a shared sense of responsibility for community well-being. This investment in community outreach and engagement strengthens relationships between Ascension, other local healthcare organizations, and the larger community. Ascension also meets regularly with governmental entities to leverage local, state, and federal resources and partnerships to support emergency preparedness and resilience. Ascension’s core mission is to treat health care as a right, not a privilege. Taking care of people, especially those at the margins, is at the heart of its actions, including planning for climate resilience. “When they need to stay warm, when they need to get out of the storm—our doors are open.”