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Sometimes it is the little things that a leader does that can make a big, big difference.  Like a weekly letter to board members.

Ten years ago, James N. Valenti, FACHE, was appointed President and Chief Executive of the struggling R. E. Thomason Hospital, El Paso’s public safety net medical center.  He inherited an array of operational, financial and clinical challenges in an unstable political environment.  The crisis was real, the need for action immediate. He moved quickly to make changes to halt a downward spiral for this facility located in one of the state’s largest, but poorest cities.

In a turnaround, it is not uncommon for the pace of critical changes to precede formal communication with the Board of Managers.  While it is understandable, it is nonetheless risky for a new CEO who is facing intense public scrutiny.  That was the genesis of the first, and perhaps one of Mr. Valenti’s more enduring public relations strategies:  a weekly letter to his Board.

Today, this letter is distributed to more than 10,000 local political leaders, key stakeholders, corporate leaders, interested residents in El Paso County, and across the country.  The actual circulation is probably higher, Mr. Valenti said, since it is frequently copied and shared locally with corporate executives, managers and even their employees.

Ten years later, the Friday letter is now part of the weekly routine for Mr. Valenti and his leadership team as well as subscribers.  In a town that once saw this hospital as a political football that took care of poor people, the organization has experienced an unprecedented resurgence.   Once known as R.E. Thomason Hospital, UMC is now the preferred hospital in the community, according to a comprehensive city survey.  There is community pride in its success and for its plans for the future.  One reason for this swell of public support can be traced back to Mr. Valenti’s letter.

The dramatic improvement in the level of community support is critical for this the only not-for-profit hospital in El Paso which is the primary hospital for the city’s large segments of uninsured and working poor.  It is also the only Level 1 trauma center for a 250-mile radius.  In 2010, University Medical Center received $52.8 million in tax revenue to support the care of the indigent. Actual expenditures for charity care amounted to $183.5 million, according to the hospital’s web site.

For Mr. Valenti, there is no question that his Friday letter has taken on a life of its own.  It was a vitally important tool to gain public support for a $315 million campus modernization program, including the construction of the West Pavilion, which opened in 2010, and the East Tower, which was dedicated in October, 2o11. Through the construction, Jim used his weekly letter to update progress on the project and sustain community support.

What was once a one-man effort to ensure timely communication with the Board, now involves the whole leadership team. As he described the production process,  I thought back to my roots in the news business and how his scheduled sounded similar to the production of a weekly newspaper.

On Tuesday they begin to look at topics for the upcoming letter.  With the support of the PR department, which now produces the written  draft,  Mr. Valenti  and the leadership team reviews the letter on Thursday.  On Friday it is published — distributed to the subscribers.   The letter always concludes with a paragraph that focuses on the weekend ahead and frequently promotes events in the community.

So, each week as the team assembles to talk about the weekly newsletter, they do so with the knowledge that this little thing, this weekly letter has made a very big difference.