Participatory Investing toolkit
Feedback Loops Exercise
The Benefit of Feedback
Participatory investing in healthcare asks institutions to move beyond consultation toward co-design, shared decision-making, and shared ownership with community leaders. This shift requires clear governance, explicit boundaries, and feedback loops that make trust visible, testable, and accountable in practice. For healthcare institutions working with community partners, feedback loops are especially critical because power, resources, and decision authority are often uneven.
Without explicit mechanisms for feedback, even well-designed participatory structures can default back to institutional control. Thoughtfully designed feedback loops help partnerships answer essential questions together: Who decides what? How do we know shared governance is actually happening? What happens when commitments are missed? And how will feedback be acted on?
This tool supports healthcare institutions and community leaders to co-define governance principles and non-negotiables, identify concrete indicators that show whether those principles are being upheld, and embed feedback mechanisms that create real-time accountability, ultimately strengthening relationships, enabling adaptation, and building durable, community-rooted investments and impact.
Step ONE
Reflecting on
Leadership and Governance Experiences
Facilitation Prompts (Individual or Small Groups)
Think of a time when you felt included in a group decision. What made that possible?
Think of a time when power was hoarded or hidden. What were the consequences?
Step TWO
Drafting Core Governance Principles
Ask the group: What are our “non-negotiables” for shared leadership?
PROMPTS
What does “shared” mean in our context?
Who decides what, and how?
What do we need in place to stay in alignment with our equity goals?
As a group, brainstorm a list of principles for how you would like to operate. This list can be narrowed using dot voting or another mechanism to land on the core 5-7 non-negotiables or governance principles for the partnership. Examples include: trust, inclusive leadership, transparency, responsiveness, etc.
Once the group has agreed on a core set, discuss the principle and how you would know if this were actualized. For this component, the group is discussing the behaviors that indicate commitment to that principle. Finally, discuss why this principle matters for your work. This will give you the language to build the case around accountability. Use the template for this work:
| Principle | Behavioral Description | Why It Matters | |
|---|---|---|---|
| Shared Power | All major decisions require input and consensus from at least 2 roles (e.g., community + institution) | Ensures no single group controls resources or direction | |
Step THREE
Embedding feedback loops to reinforce governance
As a group, read and reflect on the insights from nature regarding feedback loops. For example: Feedback loops create real-time consequences for decisions, reinforce adaptive behavior, and make trust visible and accountable.
Develop a worksheet to discuss the governance principle, how you know it is happening (behavioral indicators), what the feedback mechanism is for accountability, and how the partnership is committing to act on feedback. Use the template for this work:
| Governance Principle | How will we know it’s happening? (indicators) | What is our feedback mechanism? | How will we respond to feedback? |
|---|---|---|---|
| Transparency | Meeting notes and decisions are publicly shared | Shared drive and access logs | Gaps in access flagged and addressed in weekly huddle |
Step Four
Accountability checks
Invite the group to rate each principle quarterly on a 1–5 scale for both self and peer assessment. This can be tracked over time and revisited to support organizational learning and trust development.
1
Embedded and strong
2
3
Inconsistent but emerging
4
5
Needs major improvement