In this paper, the climate for improvement in Swedish healthcare is explored via a self-assessment model. The result from a cross-sectional survey at the clinical department level in the County Council of Östergötland is presented and discussed. The underlying theoretical model consists of three parts, first a Leadership Profile Model that contains eight leadership styles. The second part concerns organizational settings based on the European model for Excellence and the Swedish Quality award model The last part is organizational performance measured as customer and employee satisfaction. A questionnaire that covers leadership and climate for improvement has been designed and distributed to leaders at three hospitals and the Medical Laboratory units in the County Council of Östergötland. Significant positive correlations have been identified between the climate for improvement, and patient as well as employee satisfaction. These results state that clinical departments that work systematically with quality improvements have more satisfied employees and patients. The characteristics of clinical departments with a suitable climate for improvement are a focus on processes and patient involvement.