Organizational climate is a complex construct, usually measured by articulated questionnaires which include the evaluation of different aspects related to working and organizational contexts. These aspects affect the perception and the emotional experience of people at individual and group level. The Organizational Climate's questionnaires often need to be adjusted to each organizational context. In particular, the Italian National Health Service is characterized by a progressive managerialization: the role of managers in hospitals has important consequences not only on the provision of services and the implementation of Health Care Policy, but also on organization and organizational climate. For evaluating the performance in the Tuscan Health Care System, a questionnaire was designed to measure the impact of managerial competencies practice on staff. The organizational climate was evaluated through a questionnaire, that together with the classic dimension taken in account by the assessment of the climate, has also evaluated the competency of management.