Making cognitive safety standard care

We’re leading the first initiative to address cognitive harm  in health care — an urgent research and action program to improve outcomes, advance equity, and address one of healthcare’s most overlooked drivers of waste. 

The initiative aims to make cognitive safety a measurable standard of care through research, education and actionable tools; calling on health systems, clinicians, and academic partners to act now. By investing in cognitive safety, organizations can reduce harm, restore trust, and achieve measurable improvements in both patient outcomes and cost efficiency.

What is Cognitive Harm in Medicine?

Cognitive harm occurs when care overlooks patient cognitive support needs or communicates in ways that create fear, distrust, or disengagement. These breakdowns delay diagnosis, worsen outcomes, and strain healthcare systems.
“Cognitive harm isn’t rare, it’s almost universal. Everyone I have ever asked their experience, has shared at least one story of cognitive harm during the course of their medical care. It happens when efficiency pressures overtake empathy, and care becomes something done to patients instead of with them. We all pay the price of this gap in care: patients decline, clinicians burn out, and insurance companies absorb the cost.” ~ Cali Wilson
Addressing cognitive harm is vital to quality care

Cognitive harm is not currently measured in healthcare settings

While medicine has long focused on preventing physical harm, cognitive harm — remains overlooked, and worsens outcomes. Cognitive harm is exacerbated by social determinants like education and income, deepening inequity.

Patients often arrive already overwhelmed and without the support to process complex health information or participate fully in their care. Even skilled clinicians can’t overcome that alone.

Further, when patients are dismissed, invalidated, or made to question their own experience, trust breaks down.

The result? They disengage, skip appointments, and abandon treatment plans.

"There is currently no framework integrated in medicine to measure cognitive harm. We are stepping up to change that. In partnership with clinicians, health systems and patients, we can surface this long overdue conversation, and take action to implement a framework to measure and reduce cognitive harm." CW

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The Cognitive Harm Reduction in Medical Care Initiative

Deloitte research shows that direct medical costs from health inequities in health care systems could exceed $1 trillion by 2040 if left unaddressed.

Behind those numbers are patients who weren’t believed, women whose pain was labeled “anxiety,” while conditions worsened because no one paused to listen. Each time a patient leaves uncertain or unheard, the risks of missed diagnoses, repeat visits, and delayed treatment expenses rise.

For health systems and insurers, cognitive harm is a structural liability. Sustainable reimbursement models supportive of reducing cognitive harm are essential.

The initiative will address many aspects of care including: clinical communications, systemic design flaws, reimbursement models, power dynamics and how they influence  patient engagement.

By redefining those practices collaboratively, we can make medical care safer, more effective, and more accountable. 

Join us as we build a future where cognitive safety is recognized as essential to quality health outcomes.

Four pillars of the Cognitive Harm Reduction Initiative

Our initiative is built on four foundational pillars that make cognitive safety measurable, actionable, and central to quality care. Each pillar advances safer, more human-centered healthcare—grounded in collaboration.

Measurable outcomes

We co-define and track cognitive harm metrics, making invisible risks visible and actionable for care teams.

Patient resources

Guided engagement tools help patients navigate care, supporting psychological safety, and confident choices.

Provider frameworks

Clinician tools reduce overload, foster trust, and support patient understanding—improving outcomes for everyone.

System-level change

We partner with health insurance systems to embed cognitive safety into training, certification, and care delivery at every level.

Now is the time to get involved

Our initiative is a collaboration of several partnerships, organizations who are committed to urgently studying and implementing cognitive harm solutions.

Medical centers
Health insurers
Research universities
Hospital systems
Policy institutes
Philanthropic partners

Collaborate with the foundation

Join applied research to advance cognitive safety.

Work with leaders shaping measurable standards.

Help set new norms for safer care.

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Cognitive safety: your questions answered

Explore key concepts, research insights, and ways to advance cognitive safety in healthcare.

Learn more about the cognitive harm reduction initiative

Connect with us to learn how your organization can get involved.

We're inviting universities, research institutions, clinicians, patients, insurance and healthcare systems to collaborate through applied research, pilot programs, and clinical participation.
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