The importance of tacit knowledge in practices of care.
BACKGROUND
The paper argues that a high quality personal relationship between professionals and clients is a necessary condition of professional knowledge. This epistemological claim is developed against the background of current methods of quality assessment that rely on objectively measurable 'indicators'.


METHODS
A philosophical analysis regarding the nature of professional knowledge in the care sector. The analysis proceeds from Michael Polanyi's concept of tacit knowledge to account for the personal dimension of professional expertise in the care sector.


RESULTS
Quantitative methods of quality assessment understand 'quality of care' as being independent from the professional who generates it. Consequently, quality assessment as currently practiced necessarily renders the personal dimension of professional knowledge invisible, thereby excluding it from managerial attention and support. To indicate the relevance of Polanyi's concept of tacit knowledge, the paper offers some observations from the practice of care in a group home for people with intellectual disabilities.


CONCLUSIONS
The paper concludes that a high quality relationship between professionals and their clients is crucial for quality of care. This relationship generates the positive interaction that enables professionals to gain adequate insight in the needs of their clients.
Reinders
H
H
Faculty of Theology, VU University, Amsterdam, The Netherlands. js.reinders@th.vu.nl
D001519:Behavior; D017028:Caregivers; D002983:Clinical Competence; D003695:Delivery of Health Care; D004645:Empathy; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D008607:Intellectual Disability / Q000523:psychology / Q000534:rehabilitation*; D007398:Interpersonal Relations; D010361:Patients; D011787:Quality of Health Care; D013070:Speech Therapy