Ira Zunin, M.D., M.P.H., M.B.A
Medical director of Manakai O Malama

Today’s society has an abundance of quality professionals you can trust. They are well trained, highly experienced, caring and good at what they do, capable people upon whom you can rely … with one exception. Little gets done on time. Despite the best of intentions, execution is routinely delayed and, without repeated reminders, might never happen. This impairment in the conduct of business and personal relationships has reached epidemic proportions. I call it integrity diffusion. Tragically, it is the new normal.

In the era of online and mobile communications, we have the ability to maintain a plethora of personal and professional relationships — far more than ever before. So many that we fail to do them justice. Because the majority of these relationships are neither real time nor face to face, we often feel less obligated to honor our commitments and follow through on what we have agreed to.
In the old days a job application required a resume and a cover letter in a stamped envelope. Now, using Craigslist, with a few key strokes one can apply for countless jobs even if unqualified. “Yes, I’ll be there at 10 a.m. tomorrow to interview.” But then another call comes in, for a position slightly closer to home. “No problem, I’ll be there at 9:45 a.m.” Yet there is no sense of responsibility to cancel the first appointment. Result: another no-show.

A teacher of mine once said that every time we honor  commitment, it brings us power. When we fail to deliver, our human connections weaken, our personal credibility dissipates and we suffer from integrity diffusion. It not only erodes the local community. It also affects society in a pervasive manner, reducing productivity and efficiency.
It is the product of the GPS mind in which our focus jumps from one random input to another, stretching thin our relationship to self and ohana, leaving us with little sense of place.

No one is automatically immune to integrity diffusion. Not lawyers, accountants, builders, PV installers, politicians or health care facilities. “I’ll have it to you by the end of business today.” Yet in the interim a hundred other inputs touch us, and, unaware, we drift away from our commitment. It happens so often to each of us that we have come to consider it a nonissue. “Whatever, I’ll get to it in the morning.” But when we awake the next day, there is a whole new set of texts, missed calls, emails, Twitter, Facebook, Instagram, Viber, WeChat and other messages.

What to do? At Manakai o Malama we train staff to use a technique we call “Close the ticket.” When staff are asked by a patient, supervisor or colleague to complete a task, one first acknowledges the request, and a projected time to completion is agreed. This opens a ticket. The ticket is not closed until two things happen: First, the task must be completed; next, confirmation is sent to the one who made the request. If there is a delay or an unexpected challenge, possibly related to execution by a third party, that must be communicated. “I thought this would get done by lunch time, but I need another 24 hours.” The key is to remain accountable until completion and to communicate.

No one is perfect, but understanding that we live amid an epidemic of integrity diffusion is the first step toward healing this modern disease. Setting one’s intention to live a life of integrity and accountability is the next step. The third step involves maintaining awareness and focus. Step four involves active and responsible communication. Eventually, it becomes second nature. Actually, integrity is our true nature and key to being pono. Guard against integrity diffusion. Doing so will strengthen personal relationships, enhance business success and make the world a healthier place.

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