It really depends on industry and size - notably, it's ironic but smallish-medium businesses are the most stuck in old practices. They don't have shareholders or the org structure to change things, while the largest companies, makers, ad agencies, etc have largely moved forward to more outcome focused process. The hierarchy definitely still slows things down, requiring a lot of paper approvals to actually do anything. But holding your tongue in a meeting is frowned upon at at least many large cap.