Over the years the population changes in Scarborough, particularly with the broader diversity of ethnic and racial groups, have challenged The Scarborough Hospital to provide services that are culturally, racially and linguistically sensitive to a diverse community. The five major factors influencing the need for multicultural organizational change, were identified as: the changing community, public policy on multiculturalism, barriers to health care, quality improvement focus, and diversity in the workplace. This paper shares information, activities and challenges of adapting to diversity. [Based on BITRA]