93 resultados para Gestão Pública da Saúde


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The new management models have led to the reorganization of institutions today. Much is made in improving the delivery of public services entities, and they have sought to adopt these new initiatives in order to improve the quality of the product or service offered to users. The modernization of the management model at the Federal University of Rio Grande do Norte (UFRN) strengthened by the accession of the institution to GesPública Program, which focuses on the management modernization leading institutions to seek ways to fit to meet the demands proposed the Program. Therefore, the Department of Personnel Administration (DAP) has structured its processes and procedures using the mapping tool processes. This research starts from the question: what were the results obtained with the implementation of the management and process mapping of PAD? It is proposed as a general objective to analyze the management and the mapping of that Board processes, identifying the possible benefits in improving the quality of the services provided to users. The specific objectives to achieve results, are pointed out: describe how you carried out the implementation of the management and process mapping in DAP and how it is working at the moment; examine the line in the relationship between the actions developed by the DAP and modern theories of this theme; identify the evolution of the sector with the measures adopted and the results obtained with the implementation of the mapping tool. In the theoretical framework, it was approached a brief history of the evolution of public administration in Brazil, GesPública program and its importance for process management in public institutions as well as the Management and Process Mapping. The context of the study was the DAP, and participants were managers of the institution in the survey. Data collection was done through the study of the institution's documents, bibliography analysis available on the topic, questionnaires and semi-structured interviews with professionals of the institution involved with the object of study, since its inception until July 2015, when it was finished the search. As a result, were listed: the motivation, importance, benefits and innovations that management and the mapping of processes brought to the institution, point out what has been improved in the service users and the tools used. We also analyze the main problems identified during the implementation of the mapping. As a suggestion, it was analyzed how these procedures can, if possible, be extended to other sectors of UFRN.

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Over the years there has been a broader definition of the term health. At the same time it was found also an evolution of the concept of health care which in turn has led to changes in the approach to delivery of health services and hence in its management. In this regard, currently the nephrology services have been searching for quality technical and social need. In view of these innovations and the quest for quality, it elaborated the general objective: to develop a quality assessment protocol for dialysis service Onofre Lopes University Hospital. It is an intervention project effected through an action research, which consisted of 4 steps. Initially was identified through a literature search in scientific literature, which quality indicators would apply to a dialysis unit being selected as follows: infection rate in hemodialysis access site, microbiological control of water used for hemodialysis and Index User satisfaction. Through critical reflection on the theme researched in the previous step, it was drawn up three data collection instruments, interview form type, applied between the months of October and November 2015. In addition to the information obtained, also made up of the use of information retrieval technique. The results were organized in graphs and tables and analyzed using qualitative and exploratory technical approach. Then a reflective analysis of the data obtained and the diagnosis of reality studied was traced and confronted with the literature was performed. The data produced in this study revealed that the Dialysis Unit of HUOL is much to be desired, considering that some weaknesses have been identified in its structure. Faced with this finding have been proposed, as a contribution and aiming to guide the development of future actions, suggestions for improvement that should be implemented and monitored to be assured overcoming these difficulties, allowing an appropriate organizational restructuring, and resulting in improved service public offered. It was concluded that for hemodialysis treatment results are achieved and positive, it is necessary to have physical structure and adequate infrastructure, multidisciplinary team specialized, trained and in sufficient quantity, well designed processes for professionals to have standards to be followed decreasing the chance to err, and a risk management system to detect and control situations that endanger patient safety.

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Over the years there has been a broader definition of the term health. At the same time it was found also an evolution of the concept of health care which in turn has led to changes in the approach to delivery of health services and hence in its management. In this regard, currently the nephrology services have been searching for quality technical and social need. In view of these innovations and the quest for quality, it elaborated the general objective: to develop a quality assessment protocol for dialysis service Onofre Lopes University Hospital. It is an intervention project effected through an action research, which consisted of 4 steps. Initially was identified through a literature search in scientific literature, which quality indicators would apply to a dialysis unit being selected as follows: infection rate in hemodialysis access site, microbiological control of water used for hemodialysis and Index User satisfaction. Through critical reflection on the theme researched in the previous step, it was drawn up three data collection instruments, interview form type, applied between the months of October and November 2015. In addition to the information obtained, also made up of the use of information retrieval technique. The results were organized in graphs and tables and analyzed using qualitative and exploratory technical approach. Then a reflective analysis of the data obtained and the diagnosis of reality studied was traced and confronted with the literature was performed. The data produced in this study revealed that the Dialysis Unit of HUOL is much to be desired, considering that some weaknesses have been identified in its structure. Faced with this finding have been proposed, as a contribution and aiming to guide the development of future actions, suggestions for improvement that should be implemented and monitored to be assured overcoming these difficulties, allowing an appropriate organizational restructuring, and resulting in improved service public offered. It was concluded that for hemodialysis treatment results are achieved and positive, it is necessary to have physical structure and adequate infrastructure, multidisciplinary team specialized, trained and in sufficient quantity, well designed processes for professionals to have standards to be followed decreasing the chance to err, and a risk management system to detect and control situations that endanger patient safety.

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The current discussion on Education and Health has shown the need for greater integration between health services and academia, and this issue has been addressed by researchers in the area as being of great importance. How do we say what we need to do? The National Policy on Education Permanent Health proposes the dissemination of pedagogical skills at SUS, so that the public health clearance to constitute an area of teaching and learning in work performance. This study aimed to know how is the process of integration between education and health services in primary health care, from the knowledge on the role of mentors in the training of undergraduate students in the healthcare field in UFRN. Qualitative Methodology possible, from the use of the techniques of Semi-Structured Interview and Direct Observation of achieving this goal. The analysis of data taken from the Hermeneutic-Dialectic Approach, taking as mediators knowledge of the areas of Education, Health Education and Public Health, showed that the performance of preceptors constitutes an important strategy to enable the integration of teaching and service, and the professionals involved in the preceptorship educate themselves while they educate. The educational process is permeated by knowledge and experiences heterogeneous, highly favorable to the training of students and professionals factor. Innovative educational practices proven capable of starting the mediation of preceptors and other professionals involved in the Work Programme Education for Health, extend learning. The curriculum components Integrated Activity of Health, Education and Citizenship, and Tutorial Program for Integrated Health Work chosen as the basis for this experiment set, for preceptors, the need to seek new knowledge, allowing each actor transcend its specific area of academic training and interact with other areas, which makes learning interesting, enjoyable and meaningful.

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This research examined the personnel policies of the Federal University of Pará (UFPA), aimed at the middle area, implemented by the President's Office of Personnel Management (PROGEP), through the Performance Management and Development from 2006 to 2009 period, in which Institutional Plan was implemented for Technical and administrative (PIDT) with a view to ascertaining whether these actions were developed in line with the ideas of managerialism or New Public Management (NPM). The study opted for qualitative research using interview as a tool to collect data. The informants were managers PROGEP / UFPA who acted in that period. Data interpretation was based on analysis of content from the collation of speeches and documents produced during the period with the managerial categories. Data analysis revealed that the management of people, UFPA has the characteristics of a hybrid management, observing the period studied two models of management: a bureaucratic, rational, focused on processes, contemporary face of public organizations, and other managerialist, adopted by PROGEP in obedience to the mandatory policies of the federal government, being much more present the characteristics of a personnel policy-oriented processes. Concludes that the personnel policy of the UFPA has not been fully tuned to managerialism in the surveyed period

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The goal of this research was to analyze the model of strategic management of the MPRN concerning the methodological guidelines presented by Balanced Scorecard. It is based in a theoretical referential which contemplates the themes, new public management, strategic management and Balanced Scorecard, focusing on applying the methodology in the public sector. This research is classified as descriptive and exploratory. According to the methods applied, it is a case study and, according to its approach, it is qualitative. The subjects of this research are members of the institution involved in the process of its strategic management. The data was collected by means of semi-structured interviews and document analysis, done by means of method content analysis. Concerning the goal of this research, it points out that the MPRN has not concluded the implantation cycle of Balanced Scorecard, furthermore, important flaws in the steps of organizational alingment have been identified, specially when it refers to communication policy, implementing incentive actions and focused training in developing competences. It yet reveals that the implantation of BSC has allowed the introduction of changes in the Institution dynamics to seek better results, however the MPRN has faced and has not adequately gotten over the same difficulties reported in various cases of BSC implantation in public organizations

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MATOS FILHO, João. A descentralização das Políticas de desenvolvimento rural - uma análise da experiência do Rio Grande do Norte. 2002. 259f. Tese (Doutorado em Ciências Econômicas)– Instituto de Economia da Universidade Estadual de Campinas, Campinas, 2002.

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The growing importance of tourism in overall economic activity worldwide has favored the intensification of competition among cities that seek to create environments attractive to tourists and potential investors. It has been common practice to import characteristics of the business environment in the public management of cities. The city marketing is a key tool used by public leaders to promote a linkage between the tourism image and urban image and involves, in addition to promoting the image of the city, the planning of interventions in urban space, trying to formulate a positive image of the city able to facilitate the deployment of capital. This research seeks to understand the nature of city marketing as part of contemporary urban management and analyzes how is its application in decisions concerning the promotion of tourism in Natal/RN. The approach of this research is qualitative, exploratory and descriptive, in which respondents were the main leaders of two of the official tourism site, the Empresa Potiguar de Promoção Turística and the Secretaria Municipal de Turismo e Desenvolvimento Econômico. It was found that there is a strong articulation of public power with private enterprise in the design and conduct of the actions of urban marketing, that from the survey data show that the behavior of target markets provide guidelines for taking strategic decisions relating to tourism. Sun and sea are some key elements explored to form the image of Natal and to authorize the sale of the city as a tropical paradise. However, there is an increase in the diversification of tourism products, seeking to increase flow to the segments of ecotourism, adventure, business and culture. It s also growing the use of local culture as a tourism product, however, the cultural representation focuses on superficial values and does not bring to light the social and historical richness that the city has. Public authorities use the city marketing strategies as a means able to maximize the attractiveness of Natal urban space to investors, business groups and tourists. It can be observed that urban managers seek solutions that can continuously increase the tours, which often manifests in interventions that focus the tourist areas of the city, in oposition of those who do not contribute to a positive reading of the city, which ultimately generate the worsening of spacial and social inequalities

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This research investigates how functionality, rationality, and emotionality applied to urban furniture design contribute to the organization, legibility, and qualification of public spaces, according to different layouts, physical and visual qualities of the urban furniture as well as the quality of urban infrastructure that may influence the uses and appropriation of urban spaces by pedestrians, turning those spaces into socially centripetal or centrifugal places. The work consists of two parts. First refers to a bibliographical review concerning two main issues of the investigation: product design and legibility of public space, defining the conceptual and theoretical bases, linked to methodological strategies aimed at systemic planning and integrated management of urban furniture design and legibility of public spaces (sidewalks), that are necessary to define the existing relationships among the user s interface (pedestrians); product (urban artifacts); built environment (sidewalks). The second part refers to the achievement of empirical approach throughout visual analysis of public spaces and the functional and qualitative evaluation of the existing urban furniture in the central neighborhood of Cidade Alta, Natal, RN, according to the theoretical researched concepts and methodological procedures. The results expose the weaknesses and levels of intensity arising from the relations among public space, urban furniture, and users, revealing the need for theoretical and practical approaches which would help the decision-making in planning, designing and integrating innovative, sustainable, and ethical solutions in order to design attractive public spaces that could provide sociability and citizenship throughout integrated public management, city systemic thinking and urban identity. The suggested guidelines at the end of this research will provide the necessary strategies to design suitable urban furniture systems according to aesthetic and practical urban infrastructure and city context, aiming to ease visual and physical conflicts that may negatively interfere with the appropriation of public spaces by the citizens

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A Constituição Federal de 1988 e o Estatuto da Cidade estabelecem o Plano Diretor como instrumento básico da política de ordenamento territorial, tendo como princípio fundamental o cumprimento da função social da propriedade e do direito à cidade. Na perspectiva de adequação às diretrizes e objetivos da política urbana estabelecidos em 1988, o município de Natal elaborou os Planos Diretores de 1994 e 2007, definindo instrumentos e parâmetros de regulação do uso e ocupação do solo possíveis de assegurar o cumprimento da função social da propriedade urbana e de gerar subsídios ao planejamento e à gestão da cidade. Apesar de Natal ter sido um dos municípios brasileiros pioneiros na adoção desses princ pios, antecipando e incorporando os instrumentos que em 2001 viriam a ser definidos no Estatuto da Cidade, identifica-se que alguns desses instrumentos e parâmetros direcionados à regulação do uso e ocupação do solo não tiveram sua aplicação plena, a exemplo do mecanismo de acompanhamento e controle dado pelo Estoque de Área Edificável e da Densidade, que foi substituída pelo Coeficiente de Aproveitamento no Plano Diretor de 2007. Questionando esse procedimento, busca-se na presente pesquisa investigar de que maneira essa substituição do parâmetro densidade pelo coeficiente de aproveitamento influenciou na capacidade da gestão pública de regular os processos de uso e ocupação do solo, de forma a adequar a sua intensificação ao suporte da infraestrutura instalada. Foram tomadas como referência teórico-conceitual as contribuições sobre a prática de planejamento urbano no Brasil, nos marcos do ideário da reforma urbana, com destaque para as reflexõe s de Flávio Villaça, Orlando Alves Santos Junior e Daniel Todtmann Montandon, Luiz César de Q. Ribeiro, Raquel Rolnik, Ermínia Maricato, Laura Machado de Bueno e Renato Cymbalista, José Roberto Bassul e Carlos F. Lago Burnett, e, com relação aos parâmetros de controle urbanístico, o estudo identifica as diferentes abordagens sobre a densidade urbana e o coeficiente de aproveitamento com base nas reflexões de Claudio Acioly Jr., Forbes Davidson, Juan Luis Mascaró, Ricardo Ojima, Marcelo de Souza, José Rámon Navarro Vera e Armando Ortuño Padilla, Nestor Goulart Reis, Marta Dora Grostein e Susana Ricardo Alves. Como conclusão, discute-se a hipótese formulada, inicialmente, de que a mudança de parâmetros verificada colocou limites para o município realizar uma gestão adequada do solo urbano e, portanto, de fazer cumprir a função social da propriedade, considerando a necessidade de adequação entre a intensificação do uso e ocupação do solo e a infraestrutura instalada

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In a hospital environment, these bacteria can be spread by insects such as ants, which are characterized by high adaptability to the urban environment. Staphylococcus is a leading cause of hospital infection. In Europe, Latin America, USA and Canada, the group of coagulase negative staphylococci (CoNS) is the second leading cause of these infections, according to SENTRY (antimicrobial surveillance program- EUA). In this study, we investigated the potential of ants (Hymenoptera: Formicidae) as vehicle mechanics of Staphylococcus bacteria in a public hospital, in Natal-RN. The ants were collected, day and night, from June 2007 to may 2008, in the following sectors: hospitals, laundry, kitchen, blood bank. The ants were identified according to the identification key of Bolton, 1997. For the analysis of staphylococci, the ants were incubated in broth Tryptic Soy Broth (TSB) for 24 hours at 35 º C and then incubated on Mannitol Salt Agar. The typical colonies of staphylococci incubated for 24 hours at 35 ° C in Tryptic Soy Agar for the characterization tests (Gram stain, catalase, susceptibility to bacitracin and free coagulase). The identification of CoNS was performed through biochemical tests: susceptibility to novobiocin, growth under anaerobic conditions, presence of urease, the ornithine decarboxylation and acid production from the sugars mannose, maltose, trehalose, mannitol and xylose. The antimicrobial susceptibility examined by disk-diffusion technique. The technique of Polymerase Chain Reaction was used to confirm the presence of mecA gene and the ability to produce biofilm was verified by testing in vitro using polystyrene inert surface, in samples of resistant staphylococci. Among 440 ants, 85 (19.1%) were carrying coagulase-negative staphylococci (CoNS) of the species Staphylococcus saprophyticus (17), Staphylococcus epidermidis (15), Staphylococcus xylosus (13), Staphylococcus hominis hominis (10), Staphylococcus lugdunensis (10), Staphylococcus warneri (6), Staphylococcus cohnii urealyticum (5), Staphylococcus haemolyticus (3), Staphylococcus simulans (3), Staphylococcus cohnii cohnii (2), and Staphylococcus capitis (1). No Staphylococcus aureus was found. Among the isolates, 30.58% showed resistance to erythromycin. Two samples of CoNS (2.35%), obtained from the ant Tapinoma melanocephalum collected in the post-surgical female ward, S. Hominis hominis and S. lugdunensis harbored the mecA gene and were resistant to multiple antibiotics, and the specie S. hominis hominis even showed to be a biofilm producer. This study proves that ants act as carriers of multidrug-resistant coagulase-negative Staphylococci and biofilm producers and points to the risk of the spreading of pathogenic microorganisms by this insect in the hospital environment

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A dissertação avalia a efetividade do Programa de Desenvolvimento do Turismo na segunda fase (2005-2012) no município de Parnamirim/RN, busca-se verificar se este contribui para o desenvolvimento. Especificamente objetivou: a) Descrever as características e as ações do Programa de Desenvolvimento do Turismo no município de Parnamirim/RN; b) Identificar as percepções dos gestores públicos; da iniciativa privada e da sociedade civil a respeito da efetividade das ações do PRODETUR em Parnamirim e das repercussões do programa na qualidade de vida da população local; e c) Identificar as efetivações do PRODETUR na vida da população local que tenha participado de alguma ação do programa. Para tais pretensões, o percurso envolvendo a emergência e a consolidação do fenômeno turístico no seio da sociedade moderna, bem como o momento de intervenção do Estado no setor foi importante para verificar quais características estão imbuídas nas políticas públicas de turismo. Aliado a discussão do desenvolvimento para além do viés economicista, tendo as contribuições de Amartya Sen (desenvolvimento como liberdade) eixo norteador. Para a avaliação propriamente dita foram utilizadas as falas dos diversos atores locais envolvidos com o programa, compreendendo: gestão pública do turismo, iniciativa privada, sociedade civil e população local. Além de dados secundários coletados em instituições como IBGE e Secretaria Municipal/ Estadual de Turismo. Os resultados encontrados com a pesquisa nos mostraram que o PRODETUR II contribui com alguns elementos que podem cooperar para o desenvolvimento de Parnamirim/RN, pois este ocasiona efetivações significativas em cada bairro pesquisado. No entanto, é relevante observar que esses elementos estão aquém das reais possibilidades, uma vez que os resultados do programa poderiam ter sido mais substanciais. Neste sentido, ressaltamos que o fortalecimento da gestão pública e a mobilização da população local são elementos imprescindíveis para maior efetividade do PRODETUR nas próximas etapas

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The assistance to women who have breast cancer is studied in a Reference Center in Paraiba and also the way this assistance is performed in a School Hospital maintained by SUS (Single Health System) is questioned. Breast cancer demands institutional organization, provision of financial, material and human resources, requiring, from the health system, effective assistance with new technologies which make it possible for the population their access to specialized medical services although it not always is able to guarantee those services nor the rights which the legislation granted them, inhibiting a proper relationship between the health professional and the patient. The theme is discussed through a transdisciplinary knowledge view and has as its theoretical referential the contribution of classical and contemporary authors from the human and social sciences and, as an empirical research strategy, the structured interview. The objectives of the research were: identify how the assistance to women with breast cancer is carried on at a Reference Center on Oncology in Campina Grande, Paraiba, identifying their difficulties and their satisfaction with the received assistance; draw up a profile of the women with breast cancer who were assisted in this Reference Center; understand their gynecological and obstetric antecedents, life styles, age group and stage of the disease when the treatment started; check their knowledge about their rights and which benefits they had received. Most women ranged between 40 and 59 years old (63%), which corresponds to the risk range of developing breast cancer. As to their occupations, 38.3% were housewives and 30.1% retired, whose family income was among those who received between less than a minimum salary and one minimum salary (58.2%). This population was mainly constituted of married women (60.2%), whose most frequent schooling was an incomplete elementary school (27.6%) and complete elementary school (24.1%), which added up to 51.6%. It was observed that the majority of the women seemed to be satisfied with the assistance received, noting that a minimum care was enough to define this satisfaction, although it is perceived that the access to the health system does not ensure the ideal attention conditions they need; it was verified that the availability of the services and the assistance itself are seen (in the local culture) as a favor and not as a right. It is also observed that only 30% of the women mentioned that they knew about their rights and the most mentioned ones were the disease assistance (13%), the medicines (13%) and the treatment (12%), which represent the most important triad to face the disease and around which the oncologic assistance most focus on. It is concluded that the condition of the users´ minimum existential of a public health unit and the condition of belonging to a lower social stratum were variables that influenced the respondents´ satisfaction in relation to the assistance received but the importance of the Reference Center for the women with breast cancer´s assistance for the whole region cannot be denied as well as the need to broaden the way the policy of the oncologic assistance in Brazil in the local realm is seen

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This research tried to follow up with the way of intervention that a developing State promotes it regional development, once its action departs from a quantitative conception until its acting focused in maintenance, like the strategy of local development input in the Northeastern of Brazil in the 90 s. particularly, the attention was focused onto Banco do Nordeste which, between 1995 and 2002, achieved a organization changing process to get fit itself to the new conception of development and State, that advocates the maintenance and the participation of the society in its accomplishment, becoming itself the main agent of the Federal Government in the Region. By taking over the strategy of local development, Banco do Nordeste starts, at least in speech, to be less of a bank to become more of a development agent , representing some development and hope to overcome the social and economical inequalities of the Region. The hypothesis that surrounds this essay is that this reorientation experienced at Banco do Nordeste is related to three factors: timing; the Institution of a project of international technical cooperation with PNUD; the unrest of an employees group, who used to fight for the acting increase of the Bank to beyond the credit acting; and, above all, the juncture created in Ceara from the second half of the 80 s, expressed, mainly, for the political rise of a group of businessmen, who took over and modernized the standards of public management in the State, transforming the cearense experience into reference in Brazil and the world. The research was developed from information got through the use of semi-structured interviews and documental research and, as complementary resource, field observation. The interviews were done with BNB managers between 1995 and 2003, some of them current administrators (2003-2006), plus one of CAPEF directors and the present president of AFBNB. The research revealed that strategic place taken by BNB in the period studied did not come to represent a rupture in its organizational culture, being strongly attached to factors that allows its operation. When some of these elements stopped existing, it was observed a retracing in the pattern of state intervention in the Region. This conclusion restates the vision of State that guided this thesis, identified as relationships field, of different interests; space where social conflicts are established; incarnated through the institutions

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Taking as a starting point the Classic Federalism and theory of the development this Work intend to present some ideas linked about cooperation between federal entities and intergovernmental relations with the main focus the regulation by the Public Consortia aimed at administrative efficiency as a Constitutional Principle of Activity Administrative, against the current provisions of the Federal Constituition of 1988, and infraconstitutional legislation in order to provoke debate and criticism about the principle of cooperation adopted as a paradigm and the capabilities that the state has and what it is, in fact, an efficient management public. It is in the growth of the state, and not a decrease as a minimal state, which aims to discuss its role in promoting the collective interests, and it is therefore essential, as an institution able to intervene on citizens in the search for socially relevant results. Study Federalism and Development on the premise of public consortia and administrative efficiency requires study the course of history as the formation of the Brazilian State, in particular the fact that he is in joint effort between federal agencies - federal, state and municipal - in order to better review the relations established in this plan, in what concerns directly on the issue of division of powers, especially the common or competitors and the subject of the highest relevance for the implementation of an effective federal pact. Finally, the objective of this Work is not only particularize the institute of public consortia, it is intended to demonstrate the deviousness of the concept of efficiency and the division of powers of federal agencies and the constitutional contribution of the institute as a program that should be put in a tone of debate, adequacy of the practice and the law itself