Treviso, Brando and Saitovitch (2009) still affirm that this is a difficult change, that it takes time and it demands much patience on the part of the involved ones, however is a barrier that can be transposed when really the quality of the assistenciais services searchs. For Antunes and Trevizan (2000), the use of these tools requires the construction of a culture of evaluation guided for an educative paradigm that praises a continuous look for the improvement of the given service. Et.al Backes. (2007), still complete that much more that to develop and/or to implant management tools she is necessary to give emphasis in the development of a knowledge complex, capable to problematizar the way to think, to perceive, to judge and to evaluate the product of the hospital services. Recent revision of literature pointed some results that had been reached by hospitals and Brazilian services of nursing that had adopted the Management of Qualidade Total (GQT).

After to tell the experience of four hospitals that they had opted to implanting this philosophy, the research demonstrated, amongst other aspects, the happened satisfactory results of the GQT for these health institutions. The profits in human resources had been perceivable, therefore the emphasis in considering that the errors are related more to the system and less to the individuals created conditions to establish new cultural standard of relationship, of registers and analyses of adverse events and verification and checagem of the results, (BALSANELLI, 2005). The satisfaction of the patient was another profit evidenced for the study, as well as the recognition of the society by means of prizes, publications in the local press and increase of financial contributions on the part of entrepreneurs and community in general. Modifications in the pointers of hospital statistics had been distinguished also as reduction of the mortality coefficients and average of permanence and concomitant increase of the occupation taxes (BALSANELL, 2005).