What is Quality in Healthcare?
“Quality—you know what it is, yet you don’t know what it is. But that’s self-contradictory. But some things are better than others, that is, they have more quality. But when you try to say what the quality is, apart from the things that have it, it all goes poof! There’s nothing to talk about. But if you can’t say what Quality is, how do you know what it is, or how do you know that it even exists? If no one knows what it is, then for all practical purposes it doesn’t exist at all. But for all practical purposes it really does exist.” – The Narrator (Pirsig, 2009, p. 153).

Quality, as portrayed in Pirsig’s Zen and the Art of Motorcycle Maintenance, attempts to harmonize the juxtaposition of good and evil, mindfulness and apathy, rationality and irrationality, absolute, subjective, and objective truth, rationalism and empiricism, and enlightenment and unconsciousness. The existential dichotomy between quality and the human experience awakens the palette for a robust means of understanding the world. The dialogue of the narrator encourages the audience to pursue the Chautauquas, or lessons from a less monistic, unstained lens and “transcend the impulse to divide the world into separate categories of science, art, and religion (Florman & Kestler, 2014).”

Quality in healthcare yields parallels among the dualistic relationships that challenge and shape the thoughts and behaviors surrounding this elusive entity. Undeniably, the faction is in favor of quality. However, the multifaceted variables surrounding quality exist in a world where imperialism and ego are primary driving forces and that leaves little room for interpretation and clarity of a true symbiotic existence. Quality in healthcare – and in many facets of being – is in part a quest of self-identity, with quality standing as its own “self” in time and space. However, inherently, quality is not mutually exclusive from the bonds that hold the faction, the healthcare community, together. Can it be that the bigger the community and the more globalized it becomes, the fewer and more fragile the bonds? Alternatively, is the inverse revealed as the righteous self seeks that common ground? Perhaps the most basic aspect of quality is an underlying moral code – an awareness and sense of caring about what one does; and calmness in mastering the art and science of simply being. Intricately woven throughout, the esoteric doctrines of quality – community values, common vision, etc. – help preserve the basic moral code. However, this carefully orchestrated synthesis can also become shaky. Attempts to maintain the doctrines become artificial and they lose their power as adhesives to hold the community together. Although fragile, perhaps the system is not as complex as it is perceived to be. Maybe each of us carries a small piece of the puzzle and the final quest is to find the others.

References
Florman, B. and Kestler, J. (LitCharts Eds). (2014). LitChart on Zen and the art of motorcycle maintenance. Retrieved September 9, 2014 from http://www.litcharts.com/lit/zen-and-the-art-of-motorcycle-maintenance

Pirsig, R. M. (2009). Zen and the art of motorcycle maintenance [NOOK Adobe Digital Edition]. Harper Collins: New York, NY.