Effective alignment between functional departments is a critical part of vision, structure, and processes. This research defines alignment as the manner or mechanism by which organizational components, including: history and culture; vision and mission; formal and informal structures; processes and procedures; organizational metrics and measurement; relationships between functional groups; communication, and, prevailing management and leadership styles, work together in a synchronized manner in order to achieve their overall vision and objectives. At Aisling International, a large, mature, traditional organization used as a case study, alignment has been negatively affected by a disproportionate amount of "priority" items being funneled to the Focal Coalition, the group closest to the customer tasked with achieving many of the organization's objectives.

The research utilized a qualitative case study approach using data gathered from internal employee surveys and ethnographic observations in order to identify barriers to shared vision and alignment of functional groups. The characteristics found at Aisling International were compared to findings in the relevant literature.

Through the Aisling case study and the relevant literature, this research indicated that dysfunctional practices and behaviors, albeit well-intentioned, exist in organizations with strong cultures that otherwise appear to be well-aligned and performing at a high degree of efficiency and effectiveness. Such behaviors may emerge from a variety of causes, including, but not limited to: lack of shared vision between functional groups, conflicting or contradictory goals or measures, increasing numbers of directives and demands on the Focal Coalition without providing appropriate resources, micromanagement as a common practice in order to accomplish objectives, advances in technology resulting in increased capacity to provide more information on more details that, in turn, leads to increased levels of micromanagement.

Cumulatively, these behaviors funnel down through the organization, resulting in serious and chronic levels of organizational and individual stress. The research suggests that misaligned organizations are not only less efficient and responsive to customers and changes in their environment, but subject to high levels of stress on the organization and the employees working in it resulting from significant role ambiguity and cumulative overload, in turn, creating low job morale and burnout.