Perhaps the biggest challenge of organizations is that they are made up of people. And people are not as well behaved as computers are! Although we may not like to admit it, computers do pretty much what we tell them to. But people on the other hand don't necessarily do what we want, or even expect.
This means that the results of applying organizational patterns are going to be inherently less predictable than applying object-oriented design patterns, for example. Imagine that your organization uses the ResponsibilitiesEngage pattern to help communication. But perhaps two people involved simply don't like each other? Personalities play a large part in organizations.
Organizational patterns have everything to do with the culture of the organization. Remember that applying these patterns requires, in many instances, changing the organization's culture. And because culture is deeply ingrained in organizations, this can be difficult and sometimes even painful.