When the annual block party rolls around each summer, it's always a pleasure to lay eyes on all the people who share our alleys and streets, folks we typically see in passing cars and bundled up to shovel the sidewalks. Handshakes, in-quiries, gossip and the social debuts of babies born in the last year happen over the morning coffee and donuts. After the neighborhood kids meet again and size each other up, their shouts and laughter fill the street.

It doesn't take much to make friends as a child, and the block party is one of the best illustrations of this. Kids of all ages share bikes, sidewalk chalk and toys, never noticing each other's skin color, economic status or native language. This year, the thrill of tossing water balloons onto the pavement easily cut across language barriers, age gaps and cultural backgrounds.

Race, ethnicity and culture are hard to talk about, and diversity can seem like one of those topics better left to the next chairman or the PR department. But your patients need you to talk about it. The first step in meeting their needs is understanding them, and it can be difficult to do that if your trustee community bears no resemblance to the community outside the hospital's doors. What's more, every item on the agenda deserves consideration by a board with a rich variety of backgrounds and experiences.

I hope our cover story provides a comfortable starting point for a conversation about diversity. Follow that with a visit to the American Hospital Association's Institute for Diversity in Health Management website, www.diversityconnection.org, where you'll find case studies, reports and educational programs on cultural issues. The site also links to the Minority Trustee Candidate Registry, an online database of qualified candidates from diverse backgrounds who are eager to serve.

Adding ethnic, racial and cultural depth to the board may feel awkward at first. But just as with water balloons, a shared desire to improve the health of your community will lead to fast friendships.