Patient satisfaction, managers' climate orientation and organizational climate

Purpose - The purpose of this paper, in the context of hospital wards, is to test a model in which the ward manager's orientation towards a given organizational climate contributes to determine the climate perceived by medical and nursing staff, and this, in turn, has an impact on patient satisfaction. Design/methodology/approach - The design of the study is cross-sectional. The manager's climate orientation, employee perceptions of organizational climate, and patient satisfaction questionnaires were administered to ward managers, medical staff, and inpatients in 57 wards belonging to ten public hospitals in Italy. The hypothesised model was tested using two-level structural equation modelling. Findings - Different climates impact on patient satisfaction in a different way. Evidence was found that a human relation climate augments patient satisfaction. Ward managers' orientation on specific organizational models is matched by the actual climate perceived by medical and nursing staff. Comparison between alternative nested models shows that there is evidence in favour of the mediating effect of climate between the managers' climate orientation and patient satisfaction. Research limitations/implications - The main limitation of the paper is the cross-sectional nature of the data set, which does not allow for definitive conclusions on the direction of causality links. Practical implications - Understanding the link between climate and patient satisfaction may guide hospitals towards a more conscious selection of the appropriate organizational model. Originality/value - The contribution of the present paper to the extant literature is twofold. First, it verifies whether the ward manager's climate orientation is matched by the organizational climate as perceived by subordinates. Second, it investigates the mediating role that organizational climate plays between ward managers' orientations and patient satisfaction.