Inequity Inbox – How to Create a Bias Reporting System


Despite codes of conduct, individuals may consciously or unconsciously engage in microaggressions, demonstrate negative biases, and express racist, sexist, xenophobic, homophobic,transphobic, or other discriminating beliefs and behaviors. These incidents of bias may be generated by or directed towards patients, visitors, or the healthcare workforce. Such events adversely impact the experiences and wellbeing of others and may be detrimental to safety and health outcomes. The first step to encouraging safe and inclusive interactions in the healthcare setting is to collect examples of bias in order to address them. Once incidents are easily and safely reported, timely review and appropriate response can begin to shift cultural norms and create accountability.

Learn how Dr. Elena Lagon and colleagues designed and deployed the Inequity Inbox leveraging readily available survey software to better track and respond to bias in the Brigham and Women’s OB/GYN department. Dr. Lagon will provide guidance on how to set up a bias reporting system, review data and share lessons learned for responding and advancing health equity culture.

Dr. Elena Lagon is a Virginia native who earned a B.S. in Neuroscience and Theater Studies at Duke University and completed medical school at the University of Virginia. She is an administrative chief resident at the integrated OB/Gyn residency program at Massachusetts General and Brigham & Women’s Hospitals. She hopes to become a Maternal-Fetal Medicine specialist and advocate for equity, safety, and respectful care of all patients.

Health Equity – Targeted Universalism: Using Data and Co-Creation to Develop Targeted Strategies that Achieve a Universal Goal



Targeted Universalism (TU) is a framework for understanding health disparities data. Too often we stratify clinical metrics by race/payer/diagnosis but then need to ask more questions about why we see differences by group. TU is like performing a root cause analysis on health disparities data by partnering with patients and exploring the drivers of the data and co-designing solutions together. The goal is to set one universal goal for all patients but use a targeted approach to address the unique needs of each group to achieve the goal.


Learning Objectives:

  • Understanding of the Targeted Universalism (TU) framework and how it can be applied to bring about just and equitable outcomes for all while creating belonging. This training will focus on the following topics:
    • The 2 major components of the framework – universal goals and targeted strategies – how they work together, and how they are applied
    • Exploration of universal goals, why alone they do not work, but how they do work when paired with targeted strategies, and how to set them in the context of TU
    • Consideration of targeted strategies, the ways these different approaches help all reach the universal goal through different paths, why targeted strategies alone are sometimes ineffective, and how they become effective in the context of TU, and ways to develop them using data in the context of TU
    • The role of co-creation in generating and applying a wide variety of data that can clarify root causes and support the development of strategies and implementation tactics
  • Training participants will have the opportunity to ask questions, engage in discussion, and consider applications of the steps of TU.
  • Breakout groups will work through examples and exercises specific to the healthcare setting.
  • Hospital teams working on translating health equity measures into actionable quality improvement projects are encouraged to attend! The main session will be recorded and made available to all registrants.