Organizational Change Regarding Language Barriers In Healthcare

It is important to note that an effective treatment and care delivery process is highly dependent on a health professional’s ability to communicate critical and essential information to a patient. Implementing any form of change meant to improve an organization cannot be done without ensuring that the shift will be welcomed and can be integrated. The goal of change is to reduce or eliminate the Akan language barrier to improve the quality of care and safety at Montefiore Medical Center.

Organizational Culture and Degree to Which Culture Supports Change

Organizational culture plays a major role in determining the effectiveness of change. It is stated that “change-oriented leadership has a positive and significant direct effect on planned change and a positive and significant but indirect effect on planned change and emergent change” (Al-Ali et al., 2017, p. 723). Considering the fact that the organization’s leadership is proactive and transformational, it is evident that its organizational culture is flexible enough for appropriate shifts in the work processes and goals. The mission and values embrace continuous quality improvement since patient satisfaction lies at the core of the strategy, which is reflected in team engagement and communication as well as employee perception.

Organizational Readiness Tool and Readiness Assessment

Montefiore Medical Center’s culture is supportive of changes due to its leadership and management. However, it is important to know whether or not the organization is ready for shifts since willingness does not equate to readiness. In order to assess the given factors, two tools will be utilized, which are Organizational Readiness for Implementing Change ORIC and Organizational Culture Assessment Instrument OCAI. It is stated that ORIC “measures if organizational members are confident in their collective commitment towards and ability (efficacy) to implement organizational change” (Storkholm et al., 2018, p. 1). The organization’s strength shows a moderate level of commitment with high efficacy for change, where the latter indicates readiness and the former reveals willingness. The mismatch between willingness and readiness is a significant barrier to change but a weakness of the evaluation since they use overlapping inputs.

When Montefiore Medical Center is evaluated in accordance with both ORIC and OCAI tools, it becomes evident that it has a high-level readiness. It is found that when OCAI is used by a leader, it allows the latter “to gain a deeper understanding of the organizations’ current perceived culture and … pivotal in identifying the culture gap in moving toward a preferred culture over an 18-month period” (Davis & Cates, 2018, p. 71). Since culture, leadership, and readiness are intertwined, it is critical for change implementation that OCAI demonstrates the dimensional states of Montefiore Medical Center, where the leader, patients, and staff are key stakeholders. The main reason includes the transformational leader, who supports and encourages proactive action and improvement. In addition, the organization has a strong change embracing culture, which should be used as a primary resource.

Health Care Process and Systems Recommended for Improving Quality, Safety, Cost-Effectiveness

The key target improvement healthcare process and systems changes revolve around the introduction of the Akan language to improve communication, patient satisfaction, safety, quality of care, and cost-effectiveness. It is stated that “language barriers in healthcare lead to miscommunication between the medical professional and patient, reducing both parties’ satisfaction and decreasing the quality of healthcare delivery and patient safety” (Al Shamsi et al., 2020, p. 1). Therefore, the recommendation is to hire language experts and healthcare professionals with knowledge of the Akan language. The mere reduction of the communication barrier will improve the quality and safety of care. For the cost-effectiveness, hiring a medical professional with Akan language knowledge can be the best option since their skills will be valuable for non-Akan-speaking patients as well.

Strategies to Facilitate Organizational Readiness

It is evident that leadership and culture play a substantial role in facilitating readiness at Montefiore Medical Center. However, the strategy will not include these elements since they are already properly adjusted and positively tuned for change. The leader is supportive of changes towards improvements, and the culture is primed for the continuous increase in quality of care. It is stated that “nursing foundation for quality of care and supportive leadership was positively associated with readiness, change commitment and change efficacy. However, staffing and resource adequacy was positively associated only with change efficacy” (Sharma et al., 2018, p. 2798). In other words, establishing a nursing foundation for quality of care can be a highly effective facilitator for improving the readiness and willingness factors. Thus, the strategy should include supportive leadership, patient-centered culture, and a nursing foundation for quality of care.

Stakeholders and Team Members Needed

The stakeholders include the chief manager of Montefiore Medical Center, head nurse, nursing staff, doctors, and healthcare managers or administrators. Patients are not included since they will not be actively involved in the change process but will be impacted by it positively. The chief manager and the administrative staff, including managers, will be tasked with incorporating a more supportive leadership style into the organization. They will need to establish a nursing foundation for quality of care to improve readiness and willingness for change. The medical professionals will be responsible for carrying out and practically implementing the new guidelines and protocols of care. Their collective efforts will determine the overall organizational culture, which is critical for change as well. The nursing staff is the most important group since they are the ones interacting with the patients the most, which is why the foundation is designed to support them alongside the management.

Information and Communication Technologies Needed

Firstly, since there are not many Akan-speaking doctors available, one interpreter will be hired to assist the medical staff with treatment writing. Secondly, the digital healthcare translator will be installed on the work computers of each doctor to automatically translate English treatment writings into Akan ones. Thirdly, the managers will need to find the relevant professionals for designing and improving the tool to make it applicable to Montefiore Medical Center.


Al Shamsi, H. Almutari, A.G., Al Mashrafi, S., &Al Kalbani, T. (2020) Implications of language barriers for healthcare: A systemic review, Oman Medical Journal, 35(2), 1-9.

Al-Ali, A. A., Singh, S. K., Al-Nahyan, M., & Sohal, A. S. (2017). Change management through leadership: The mediating role of organizational culture. International Journal of Organizational Analysis, 25(4), 723-739.

Davis, R., & Cates, S. (2018). The implementation of the organizational culture assessment instrument in creating a successful organizational cultural change. International Journal of Business & Public Administration, 15(1), 71-94. Web.

Sharma, N., Herrnschmidt, J., Claes, V., Bachnick, S., De Geest, S., & Simon, M. (2018). Organizational readiness for implementing change in acute care hospitals: An analysis of a cross-sectional, multicentre study. Journal of Advanced Nursing, 74(12), 2798-2808.

Storkholm, M. H., Mazzocato, P., Tessma, M. K., & Savage, C. (2018). Assessing the reliability and validity of the Danish version of organizational readiness for implementing change (ORIC). Implementation Science, 13(1), 1-7.