Healthcare communications is a niche area of the professional communication field that has been studied from a social identity perspective by several researchers. In this qualitative study, interviews and documents were collected to evaluate the relationship between internal communications and social identity at St. Michael’s Hospital in Toronto, Ontario. Results showed a process of internal communications management that began with planning communications, moved through implementation and then involved measuring communications practices and planning for future changes. Throughout this process, the ‘unique identity’ of St. Michael’s Hospital was used as an inspiration for communications planning, messaging and measurement in order to reinforce a valid identity for employees. Moving forward, the public affairs and communications department could further expand their staff training and measurement tools in order to further solidify their status as an adaptive communications system.