Improving the Performance of Hospital Employees Reviewed from the Perspective of Organizational Culture, Organizational Citizenship Behavior, and Organizational Commitment

This study aims to explore the Environmental Implications of Organization, Organizational Citizenship Behaviour (OCB), and Organizational Commitment to Employee Performance. The study used a quantitative approach, the number of samples used in the study as many as 58 employees. The data collection technique used in this study is in the form of questionnaires. Data analysis techniques used in this study are structural equation modelling (SEM) based on variance or component-based SEM, famously called Partial Least Square (PLS). There were 5 relationships examined in the influence of Organizational Culture on OCB (14,060 > 1,960), The Influence of OCB on Employee Performance (2,213 > 1,960), Organizational Cultural Influence on Organizational Commitment (12,516 > 1,960), organizational commitment influence on employee performance (3,783 > 1,960), organizational cultural influence on employee performance (19,293 > 1,960). All of the relationships studied showed positive and significant results, according to t-statistics > t-table (1,960). From the results of this study, it can be known that employee performance can be achieved if the conditions of the employees are in an optimal situation. Whether the individual condition of the employee itself, relationships with co-workers, the work environment or relationships between divisions established during the work process.


INTRODUCTION
As one of the health care institutions, the hospital becomes a place to get health facilities and services for people in need. especially in the current pandemic period, the existence of hospitals becomes an agency that is very calculated its existence (Mosadeghrad et al., 2011;Yoon & Lim, 1999). Not only medical personnel play an important role but non-medical personnel also have their own contributions in supporting the service process in the hospital (Bauernfeind et al., 2021;Lamiani et al., 2021). The focus of this research was also carried out on non-medical personnel at Buleleng regency hospital. The different role between medical personnel and non-medical personnel becomes a very interesting thing to research, how the role of non-medical personnel in supporting everything related to the technical work of the hospital. This phenomenon becomes interesting to be studied, therefore the focus of this research was also carried out on non-medical personnel at Buleleng Regency Hospital. Conduct a review of employee performance assessed from the perspective of organizational culture, organizational citizenship behaviour, and organizational commitment.
Being able to work well and make a full contribution to the agency is a very important thing that must be owned by all hospital employees in carrying out every task and responsibility. But if every employee is able to contribute more by willing to work not only focus on his duties is more value that can have a positive impact on the performance of the employee itself. OCB is a positive social behaviour carried out by employees by contributing to the organization and its work environment that exceeds the demands of roles or positions in work (Nisa et al., 2018;Rembet et al., 2020). This behaviour can be referred to as extra-role behaviour or good citizens who are social creatures by prioritizing the public interest over personal interests. Previous research on the effect of organizational citizenship behaviour on employee performance from the results of his research showed OCB has a positive and significant influence on employee performance (Chelagat et al., 2015;Lestari & Ghaby, 2018). This makes employees more reluctant to engage with each other and have discussions before taking a job. Furthermore, another research entitled role of organizational citizenship behaviour (OCB), perception of justice and job satisfaction on employee performance, showed the same results OCB positively and significantly affect employee performance (Hidayah & Harnoto, 2018). The same research was also obtained OCB results had a positive and significant effect on employee performance (Bustomi et al., 2020;Purwanto et al., 2021).
In its realization, the improvement of employee performance is also influenced by other factors that have implications including organizational culture and organizational commitment (Bustomi et al., 2020;Kuswati, 2020). All of these variables are interrelated and influential according to the relationships studied in the study. Organizational commitment becomes a condition used to measure and evaluate the strength of an employee in surviving and carrying out his duties and obligations in an institution, while organizational culture is a common perception agreed by all members of the organization. Organizational culture is concerned with how employees perceive the characteristics of an organization's culture. Previous studies with the same theme of the influence of organizational culture and organizational commitment to employee performance (Dewi & Hasniaty, 2017;Lengkong et al., 2018;Muis et al., 2018). From the results of their research, it can be known that organizational culture and organizational commitment have a positive and significant influence on employee performance. This shows, through the application of organizational culture can form the commitment of employees to work to carry out their duties and responsibilities so that employee performance can be realized. This study aims to explore the Environmental Implications of Organization, Organizational Citizenship Behaviour (OCB), and Organizational Commitment to Employee Performance. This study interested in reviewing organizational cultural relations, organizational citizenship behaviour, and organizational commitment to employee performance at Buleleng regency hospital. Especially in the current pandemic situation, specifically the author wants to know how employees still have a commitment to provide health services for the community.

METHODS
The method used in this study is a quantitative method, which describes a causality relationship between variables (Sugiyono, 2014). This study examined the causal relationship between organizational culture variables, organizational commitment, organizational citizenship behaviour, and employee performance at Buleleng regency hospital. In the current pandemic situation, hospitals are required to be able to continue to provide maximum service to the community through improving employee performance by paying more attention and adjusting the needs of employees. This research was conducted at Buleleng Regency Hospital with a focus of research conducted on Non-Medical Employees both civil servants (PNS) and contracts. Non-Medical Employee Selection is used as a sample to find out how much contribution employees are involved in the process of surgery in hospitals, especially in the current pandemic situation. The population in the study was 118 people from 9 subsections, and the sample used was 58 employees. Questionnaires are used as data collection techniques with a Likert Scale of 1-5. There will be a reliability test and validity test before the data analysis, the standard for reliability values is used Cronbach's Alpha standard (0.60) and validity test by comparing correlation values (rcalculated) with r-tables.
Data analysis techniques use SEM (Structural Equation Modelling) analysis using the PLS (Partial Least Square) method (Ghozali, 2014). The stage of data analysis is: The first stage is to evaluate the measurement model (outer model). Test validity and reliability by performing Convergent Validity, Discriminant Validity Composite Reliability, Cronbach's Alpha and AVE. Formative indicators are tested with weight significance and multicollinearity. The second stage is to evaluate the structural model (inner model). Evaluation in this model will be seen from the coefficient of determination (R2), predictive relevance (Q2), goodness of git index (GOF). Hypothesis testing is seen from t-statistical values and probability values. Hypothesis testing uses statistical values, so for alpha 5% the statistical t value used is 1,960.

Assess the Outer Model or Measurement Model
Constructs can be expressed to have high reliability if the composite reliability value is above 0.70, Cronbach's Alpha value above 0.60, Rho_A above 0.70, and AVE above 0.50 (Ghozali, 2014). Table 1 presented the values Cronbach's Alpha, Rho_A, Composite Reliability and Average Variance Extracted (AVE) for all variables. on the waiting model are above 0.5. The lowest AVE value of 0.740 lies in the Organic Commitment construct, so it can be concluded that the construct in this study is valid. And for the value of rho_A all constructs are already above 0.70. Measurements for the magnitude of the correlation between constructs and latent variables can also be seen in the path diagram in Figure 2. Figure 2 shows all variable indicators have a loading factor value above 0.5, this proves all variable indicators are valid.

Structural Model Testing (Inner Model)
Structural model testing is performed to determine the relationship between latent constructs in the research model. The inner assessment of the model can be seen from R Square for all dependent latent variables (Ghozali 2014). Table 2 presents the value of R Square.

Hypothesis Testing
The main basis used to test hypotheses is the value found in the output output for the inner weight. Table 3, explains the results of hypothesis testing (next page).  Table 3, it can be known that all relationships studied have a positive and significant influence. The first relationship, OCB has a positive and significant effect on Employee Performance in accordance with the results shown, namely the parameter coefficient value of 0.290 with a t-statistical value of 2.213 which is greater than the t-table value of 1,960 (2,213 > 1,960). The relationship between the two Organizational Commitments had a positive and significant effect with a parameter coefficient value of 0.426 and a t-statistical value of 3.783 greater than t-table 1,960 (3,783 > 1,960). The third relationship of Organizational Culture has a positive and significant effect on Employee Performance with a parameter of value of 0.809 and a t-statistical value of 19,293 greater than t-table 1,960 (19,293 > 1,960). Organizational Culture has a positive and significant effect on the OCB with a parameter coefficient value of 0.809 and a t-statistic of 14,060 greater than the t-table value of 1,960 (14,060 > 1,960). The fifth relationship, Organizational Culture has a positive and significant influence on organizational commitment with a parameter coefficient value of 0.735 and a t-statistical value of 12,516 greater than the t-table value of 1,960 (12,516 > 1,960).

Influence of Organizational Culture on Employee Performance
Based on the results of the study, Organizational Culture has a positive and significant effect on Employee Performance in Buleleng Regency Hospital. This shows that the organizational culture applied International Journal of Social Science and Business, Vol. 6, No. 1, 2022, pp. 39-46 43 Luh Kartika Ningsih / Improving the Performance of Hospital Employees Reviewed from the Perspective of Organizational Culture, Organizational Citizenship Behavior, and Organizational Commitment in the hospital has become a complete part with employees. Culture that has become the identity of an agency indirectly also forms members of its organization also has an organization and contributes it fully and maximally. So, this situation also makes the employees continue to strive to improve their performance by providing maximum service to the community. The results of this study are also supported by research on the influence of Organizational Culture on Employee Performance where in the results of research it is known that an employee will be able to continue to improve his performance because he already understands what is the Culture in his agency (Syurya et al., 2019). This is because employees have strong trust and accept the values of the organization's goals. The same research results were also found that organizational culture positively and significantly on employee performance in each agency, namely PDAM Majalengka Office, Dungingi Camat Office, and Telkom Indonesia University. From the studies they do every employee already has a strong value to the culture applied in his agency (Dunggio, 2020;Isnada, 2016;Kuswati, 2020;Rohman et al., 2021). Evident from the strong results of employee performance assessments that have been done on the understanding of organizational culture owned. So it can be known from the understanding of the value of a strong organizational culture able to create maximum employee performance, and can make a good contribution to the organization's goals. So as to be able to realize what has become the vision and mission of an organization.

The Influence of Organizational Culture on Organizational Citizenship Behavior
From the results of hypothesis testing, it is known that organizational culture has a positive and significant effect on OCB in Buleleng Regency Hospital. Employee awareness to establish a very good teamwork relationship is evidenced by the results of considerable significance. Buleleng Regency Hospital employees, especially non-medical employees, showed seriousness in carrying out their respective duties and responsibilities. Work closely with the team to support every work program undertaken to achieve the organization's goals by providing health services to the community. This shows that most employees are able to put themselves in their respective positions but still engage in other work if colleagues or other divisions are in need of help. So that all work and responsibilities can be completed properly and maximally.
The high value shown in the influence of organizational culture on OCB, none other than the good understanding and application of organizational culture in the Buleleng Regency Hospital. A good understanding of the cultural values embraced has an impact on OCB employees, without any coercion from any party, employees will synergize and work together to help each other. Indirectly this condition fosters the awareness of employees to continue to increase awareness of the work environment. The results of this study are also supported from the results of previous research with results that promote positive and significant influence of organizational culture on OCB (Ariani et al., 2017;Arumi et al., 2019;Arundita et al., 2021;Mahardika et al., 2018;Muttaqien, 2021;Puspita & Dewi, 2020;Zahreni et al., 2021).

The Influence of Organizational Culture on Organizational Commitment
Building a commitment is very important in every relationship. So is the relationship that is built between the workers and their agencies. Work commitment to the organization becomes a reflection of the actions of employees to still be able to contribute to the maximum through work actions carried out. As well as in the employees of Buleleng Regency Hospital, the commitment of the organization that is well formed, able to make a positive contribution to the agency this is the realization of the employee's understanding of the cultural values embraced. Organizational culture at Buleleng Hospital can be well understood and has a positive impact on organizational commitment. From the results of data analysis shows the value of organizational culture has a good influence on organizational commitment. This proves that the understanding of the cultural values of the organization of Buleleng Regency Hospital employees is very good so that it has a positive influence on the organization's commitment. Working optimally and providing excellent service to the community is the main key in the implementation of every task and responsibility and is a commitment that is firmly held by the employees of Buleleng Regency Hospital. It can be known that the better the understanding of organizational cultural values, the better the organizational commitment. The results of this study are also supported by several previous research (Chanana, 2021;Heriyanti & Zayanti, 2021;Pham Thi et al., 2021;Yanto & Jaenab, 2020).

The Impact of Organizational Commitment on Employee Performance
Having human resources that have good performance becomes the goal of every agency. Being able to improve employee performance through the work process that has been done will be a must in order to make a positive contribution to the agency. As is the case with employees in Buleleng Regency Hospital, from the results of data analysis that has been done it can be known that the value of employee performance shows good results, especially when influenced by organizational commitment. This is a condition that is commonly done by employees when carrying out their duties and responsibilities. The commitment to always be able to provide the best service to the community, especially the patients, becomes a positive thing that has an impact on the performance of Buleleng Regency Hospital employees. The strong commitment and high awareness of employees for all their obligations will indirectly shape the character of employees in order to provide the best for the company by showing maximum performance results. So that high commitment will make employee performance better. The same results were shown in research with the results of organizational commitments affecting employee performance (Ginanjar & Berliana, 2021;Kristian & Ferijani, 2020;Putra et al., 2021;Rembet et al., 2020;Safitri et al., 2021).

Effect of Effect of OCB on Employee Performance on Employee Performance
The last relationship examined in the study was the effect of OCB on employee performance. In this relationship shows the results of OCB positive and significant influence on employee performance. As discussed in the previous relationship, each variable shows good value and is able to show in the activities that are commonly carried out by employees in Buleleng Regency Hospital both OCB value and employee performance. The willingness of employees to be willing to engage with each other in every work activity carried out fosters a sense of high responsibility and indirectly trains solid teamwork. Because every employee is concerned about the difficulties felt by his coworkers then willing to help and complete the task together. This condition then forms concern for each other both individually employees and relationships between divisions. With the good relationships between divisions, especially employees, this can have an impact on improving employee performance. So, the better the OCB, the better the performance of employees in Buleleng Regency Hospital. And here are some studies that show the same results (Halim & Dewi, 2018;Lestari & Ghaby, 2018;Sari, A. et al., 2021;Suzana, 2017;Yuwanda & Pratiwi, 2020).

CONCLUSION
Employee performance can be achieved if the conditions of the employees are in an optimal situation. Whether the individual condition of the employee itself, relationships with co-workers, the work environment or relationships between divisions established during the work process. From this study, there are also many things that can be seen care and preparedness for every condition that is being faced in certain situations forms the character of employees to be ready under any circumstances. Working with a high commitment, understanding of the needs of a good organization, and the application of cultural values that have become a habit becomes a very important thing to be owned by every employee in Buleleng Regency Hospital. Being able to make the best contribution to the agency is an obligation that must be shown by every employee with the aim to continue to be able to improve the performance of employees who will later have an impact on the progress of an agency. Indirectly, good things that have been embedded in every employee, can provide a positive vibration for the performance of employees in particular and the success of the agency in general. Further research is expected to contribute more related to other variables that can be researched for the development of theory in general and its direct impact on agencies in particular.