A building as shelter is designed to provide an indoor environmental quality (IEQ) that is comfortable and appealing to its users. Having the understanding of the relationship between IEQ performance in buildings and the overall satisfaction derivable from the environment by the building occupants are necessary variables that will enhance the formulation of the requirements for architectural and building systems design and control. This study is aimed at developing a conceptual framework model for evaluating the performance of IEQ and occupants' satisfaction in hospital ward buildings. This conceptual framework is based on hypothesised model constructs, using Confirmatory Factor Analysis (CFA) and Structural Regression Models (SRM). The data were analysed, using Structural Equation Modelling (SEM). The analysis of the different specified model constructs in the framework resulted in an evaluation model for IEQ performance (IEQ(pm)) and occupants' satisfaction (IEQ(pos)) in hospital ward buildings. The IEQ(pm) model indicated that thermal quality, acoustic quality, visual quality, and indoor air quality (IAQ) are significant determinants of IEQ performance indirectly measured through the interrelationship among ten different indoor environment indicators. However, the level of importance of the four parameters of the IEQ performance differed, having different weighting factors of 0.61, 0.53, 0.40, and 0.47. The significant relationship between IEQ performance and occupants' satisfaction as established by the IEQ(pos) model resulted into a single index score value called 'Comprehensive Occupant Satisfaction' Index (COSI) which can be used for the assessment of occupancy comfort survey aspect of IEQ criteria in green building rating system.