Alignment: Impact on implementation processes and outcomes

Abstract

The concept of alignment arises in a number of forms throughout the implementation literature as being a critical element for implementation success although sometimes with different labels such as “fit” or “congruence”. In this essay, we define alignment as the extent to which various elements internal to the organization or between the organization and external entities are congruent, consistent, and/or coordinated. We draw heavily from the literature on organizational climate and culture and describe five types of alignment that are critical for implementation effectiveness: internal systems alignment, horizontal unit alignment, vertical alignment, innovation-client alignment, and innovation-provider alignment. We recommend that alignment both within and across levels of context be elevated to a key consideration in implementation theories and strategies, as well as in practice with implementation leaders. Doing so will promote a greater understanding of the complex implementation environment and should lead to more nuanced and effective implementation strategies.