Organizational structures refer to how the parts or components of a health organization relate to each other; in other words, how the organization is "put together". Health care facilities are commonly split into discrete departments or units, each operating separately from the others. However, though they may operate separately, each department in a health care organization is dependent on how well other departments can respond to a patient. This interaction between departments has a direct affect on patient flow and the effectiveness of your operations.

When it comes to language access, interpreters interface with every aspect of the organization. A common expectation is that interpreters are easily accessible, so structures to enable their work are not developed. However, this expectation is inaccurate – interpreters are often spread too thin and the ability of health care organizations to provide quality health care suffers as a result. Since most health organizations are not designed to service patients with language barriers, organizational structures such as policies, procedures or designated staff are needed to create organized and effective responses. All departments, and the many functions that support a patient encounter, need thought-out pathways to guide their response to patients with language barriers. These pathways need to be compatible with how interfacing departments function. For example, the telephonic switchboard may not need to have a dedicated interpreter on staff; however, arrangements for bilingual operators or interpreters should be established to enable the operator to handle calls from patients unable to speak English.