Patient satisfaction has become an important indicator of process quality inside hospitals. Even so, the improvement of patient satisfaction cannot simply follow from the implementation of new incentives schemes and organisational arrangements; it also depends on hospitals' cultures and climates. This paper studies the impact of alternative models of organisational climate in hospital wards on patient satisfaction. Data gathered from seven public hospitals in Italy are used to explore this relationship. The theoretical approach adopted is the Competing Value Framework which classifies organisations according to their inward or outward focus and according to the importance assigned to control vs. flexibility. Results show that both a model stressing openness, change and innovation and a model emphasising cohesion and workers' morale are positively related to patient satisfaction, while a model based on managerial control is negatively associated with patient satisfaction.