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Sometimes it pays to take a risk.

The San Antonio Hospital Foundation of Upland, CA sent out a 5,000-piece mailing last November to solicit donations for a new emergency room. It went to prospects with home values of $500,000 or more.

What made it different was the cost: $24,000, more than double the usual budget for a direct mailing.

And it landed a $100,000 donation within three weeks — twice what's generated for the hospital by mail in a year.

Now the foundation is deciding whether to make the new creative its standard, says Christie Rose, manager of special events and annual giving.

Designed by Positive Response, a Dublin, OH lettershop, the new package features puzzle pieces that form an aerial photograph of the hospital. In contrast, the standard mailer includes a torn letter; recipients use an enclosed Band-Aid to patch it back together.

But the jury's still out as to which one works best.

Despite the big contribution, the November mailing pulled a 0.46% response rate, lower than the 1% the foundation usually gets. And a second drop in December wasn't as successful as the first. But it could be in time.

“We usually wait two to three months before we know what the actual rate is,” Rose says.

The decision to spend money on the new creative was approved by the hospital's president, according to Rose: “Sometimes you've got to spend money to make money.” The sum included printing and postage.

In addition to direct mailings, San Antonio raises funds through an annual golf tournament and dinner, which together bring in about $300,000, Rose notes.

But the recent mailing's success has kindled an internal debate about whether to increase mail frequency.

While such a decision isn't made by the hospital's board of directors, “we don't want to do anything the board might not like, especially when it comes to spending money,” Rose says. (She explains that the hospital, located 60 miles north of Los Angeles, runs the foundation.)

Another outgrowth of the campaign is the question of hiring a direct mail agency, Rose adds. Her three-person staff usually manages the mailings, and doesn't have the time or ability to do things like track mail packages.

But there are a couple of downsides to outsourcing. One is the expense; another is an outside agency's probable insistence that the hospital send at least six mailings a year.

“They say you need six mailings to establish a control group and so people [will] notice your name,” Rose says. “But if we increase our mailings it would probably only be to three.”