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Tips for writing a LOR?

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I have minimal interaction with pre-PA students so I haven't written many LORs. I've actually only written two (one person, 2 years in a row) and she didn't get in either year despite being an outstanding candidate IMO. Can someone experienced with writing good LORs provide some tips? I'm not even sure what schools look for these days. Thanks!

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I write a short note about who I am and then write the rec based on what the strengths of the candidate need to be. That might be work ethic, team skills, communication, medical skill etc. I try to target the position I am writing the letter for.

I used to write letters frequently but decided several years ago to limit myself to one a year. I state that in my letter... something along the lines of "I am asked several times a year to write a letter of rec but limit myself to one a year. (Name) is the person most deserving of this letter."

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