The most annoying problem with multiple Exchange accounts in an Outlook 2010 profile is the ridiculous number of calendar and contact folders cluttering up the navigation pane. There are ways to deal with the extra folders.
Microsoft developed a PST Capture tool that will help administrators search the network and discover pst files - then import them directly into users' primary mailboxes or archives.
While you can create a custom form that will apply to all new contacts, the business card image on existing contacts won't be updated. This is to preserve any business cards you may have already updated. If you really want to update the business card image on your contacts, you can use VBA to quickly make the change. We have code samples to change both the card image and the layout with BusinessCardLayoutXml.
How to remove the Most Recently Used (MRU) lists from Outlook. This includes the Location field in Appointments and Open other user's folder list.