IMPLEMENTATION OF A MODEL FOR IMPROVING RADIOLOGY STAFF PERFORMANCE BASED ON ORGANIZATIONAL CULTURE AND COMPETENCY

Good human resources are one of the crucial factors in health care institutions. Improving employee performance and achievement will have an impact on improving company performance. This study aims to determine the extent to which radiology staff performance is influenced by organizational culture, competence, and motivation and implement performance improvement using performance appraisals and potential estimates. The object of this research is the three branches of the XYZ hospital group. The sample in this study used saturated sampling, with the entire population being the sample. Statistical tests use SEM PLS. Based on the analysis results, it is proven that organizational culture and competence have a positive and significant effect on the performance of radiology staff. Organizational culture and competence have a positive and significant effect on the work motivation of radiology staff. Motivation can mediate the indirect influence of organizational culture and competence on the performance of radiology staff. Implementation of performance improvement models using performance assessment and potential estimates. All hypotheses in this research are proven and acceptable. Organizational culture and competence directly and indirectly affect the performance and motivation of radiology staff. DOI


INTRODUCTION
Hospitals provide health services to individuals and provide superior care services to their patients by balancing improving the quality of hospital services with improving the performance of medical personnel (Minister of Health of the Republic of Indonesia, 2019).
Good human resources are a crucial factor in health service institutions.Increasing staff performance and achievements will have an impact on increasing company performance.HR is necessary for institutional leadership because humans are the locomotive that directs and determines the organization's progress toward future challenges (Neksen et al., 2021).
This research is essential to carry out because the performance of the radiology staff in the XYZ hospital group is one of the crucial determinants when determining the success of achieving the company's vision and mission.In the 2019-2021 period, there was an increase in the performance assessment of radiology staff on the elements of integrity, commitment, trust, and compassion.Only the element of professionalism experienced a decline in 2021.In 2019, the average professionalism assessment was 3.57.In 2020, it was 3.74; in 2021, it decreased by 3.69.The decrease in performance assessment, which was only found in the element of professionalism in the 2021 period from an average of three branches of XYZ Hospital, is the reason for the author to look for factors that are To find out and analyze the influence of competency on the motivation of radiology staff in the XYZ hospital group.Knowing the indirect influence of organizational culture on performance with motivation as mediation.Knowing the indirect effect of competence on performance with motivation as mediation.To determine, analyze, and design a performance appraisal evaluation form based on organizational culture, competency, and work motivation variables.
The benefit of this research is that the research will determine how organizational culture and competence influence the performance of radiology staff in the XYZ hospital group, with motivation as a mediating variable.It is hoped that the research results can help companies consider and overcome relevant problems related to organizational culture, competence, motivation, and performance of radiology staff in the XYZ hospital group.It is hoped that this research can be a source of additional research and increase knowledge about the field of HR management, especially issues of organizational culture, competency, and motivation related to the performance of radiology staff (Rohim & Budhiasa, 2019).

METHOD
The type of research used is quantitative with an observational survey approach.The population in this study was 40 radiology staff at the XYZ hospital group.In this research, the sampling technique used a saturated sampling technique.The number of research samples this time was 40 respondents.The variables researchers use in this research are exogenous, endogenous, and mediating variables.The exogenous variables in this research are organizational culture and competence.The mediating variable in this research is motivation.The endogenous variable in this study is the performance of radiology staff.Data processing and analysis methods that use partial least square (PLS) are very effective.This method is often referred to as soft modeling because it can eliminate regression assumptions / OLS (ordinary least square) or multicolonicity problems between exogenous variables.

RESULTS AND DISCUSSION
The research results show that organizational culture, competence, and motivation positively and significantly affect employee performance.Furthermore, motivation can also mediate the influence of organizational culture and competence on employee performance.
The influence of each research variable when linked to theory and previous research results can be explained in a detailed discussion of the research results as follows:

The Influence of Organizational Culture on the Performance of Radiology Staff
The regression coefficient result of organizational culture on the performance of radiology staff is 0.259, which is positive.Calculated t value (2.349) > t Table ( 1,68 ) and the p-value is 0, 0 10 (significant), the research results show that organizational culture directly has a positive and significant influence on the performance of radiology staff in the XYZ Hospital Group.This means that the higher the organizational culture that is implemented, the higher the performance of radiology staff will be.
The results of this research align with the findings of researchers, who concluded that organizational culture continuously influences the performance of nurses at the initial hospital in Bros Batam (Susilowati et al., 2020).This is also in line with research conducted by researchers concluding that there is a high correlation between performance variables and the relationship between organizational culture variables (Djaman et al., 2021).The results of research conducted by researchers show that organizational culture has an impression on the performance of Kupang City Alak health center workers (M.Damanik et al., 2023).Researchers showed that organizational culture influences hospital employee performance (Bilqis et al., 2023).
The innovation and risk-taking dimensions have the lowest mean with a value of 3.38 in the medium category, especially the reward indicator for innovative ideas, which has the lowest value with a mean of 3.15 in the medium category.From the results of field interviews, several staff felt that the radiology department needed to give more appreciation for the efforts carried out by radiology staff.This can be a note for the head of radiology to provide a higher appreciation for new ideas.The ability of the head of radiology to accommodate the innovative ideas of radiology staff can spur the performance of staff in the radiology department.The development of advanced technology, examinations, and software in radiology will have more significant potential for use by radiology staff who can think innovatively.
The attention to detail dimension is known to have the highest mean of 3.54 in the high category.This shows that the radiology department has provided good SOPs or work procedures, and the radiology staff is committed to implementing good work SOPs.This needs to be maintained by the head of radiology to maintain the performance of the radiology staff.

The Influence of Competency on the Performance of Radiology Staff
The results of the competency regression coefficient on the performance of radiology staff were 0.328, which was positive.Calculated t value (3.574) > t Table ( 1,68 ) and the p-value is 0, 0 00 (significant); thus, the research results show that competence directly has a positive and significant influence on the performance of radiology staff in the XYZ Hospital Group.This means that the higher the competency, be it knowledge competency, skills competency, or behavioral competency, the better the performance of radiology staff will be.
The results of this research align with research conducted by researchers, which concluded that competency has an essential influence on the performance of nurses in RSJ Bali Province (Darma Laksana & Ariani Mayasari, 2021).Research conducted by researchers produced competency variables related to high influence on employee performance (Setio & Gulo, 2021).Researchers explained that competence simultaneously had a significant effect on the performance of nurses at the early Bros Batam Hospital (Susilowati et al., 2020).Research produced by researchers expressing competence influences the performance of hospital employees (Rusvitawati et al., 2019).
The knowledge dimension gets the lowest score with a mean of 3.27, with the lowest indicator in getting job-appropriate training with a score of 3.25.This shows a need for formal education in the field of radiology.This is reinforced by the characteristics of respondents with a Diploma education level of 27 respondents from 40 populations, or 67.5% of the total population.Knowledge of radiology can be obtained through education, and radiology staff's skills can be honed through the repetition of work activities and regular training programs.This can be input for the head of radiology when looking for new employees to emphasize that a Diploma IV or Masters in Applied Radiology may need to be considered further in looking for new radiology staff formations to increase knowledge at the radiology staff level.The head of radiology can consider increasing the competency of radiology staff by providing scholarships for Diploma III staff to obtain a higher level of education in the field of radiology.Another note is managing fund allocation training and development and focusing on developing work skills.
The behavioral dimension received the highest score in the respondent's description, with a value of 3.74.The willingness of radiology staff to help other staff if they need help with radiology staff's compliance with radiology SOPs is the key to success in maintaining the polarization of behavior of radiology staff.

The Influence of Motivation on the Performance of Radiology Staff
The regression coefficient result of motivation on the performance of radiology staff is 0.453, which has a positive meaning.Calculated t value ( 3.833 ) > t Table ( 1,68 ) and the p-value is 0.00 0 ( significant); thus, the research results show that motivation directly has a positive and significant influence on the performance of radiology staff in the XYZ Hospital Group.This means that the higher the employee's motivation, be it physiological needs, safety, social needs, self-esteem needs, and self-development, the greater the performance of radiology staff will be.
The results of this research are in line with research conducted by researchers which explains that motivation has a significant relationship to the performance of Medan Mitra Medika Hospital nurses (Astuti & Lesmana, 2019).Overall, research conducted by researchers shows that motivation substantially impacts the work motivation of Nur Hidayah Hospital employees (Mudayana, 2014).Research conducted by researchers suggests that motivation influences the performance of employees at the Kupang City Alak Community Health Center (M.Damanik et al., 2023).The results of the journal completed by researchers show that motivation variables positively and significantly influence the performance of the Jala Ammar Makassar Marine Hospital (Almukarom et al., 2019).Researchers results explain motivation variables' significant and positive influence on staff performance (Nauli, 2021).
The security need dimension was ranked lowest, with an average value of 3.16.Even though most radiology staff feel the need for a sense of security is sufficient, there are still radiology staff who are worried about it.The old age security indicator has the most minor average, with a value of 2.97.By working in a private company, several radiology staff are worried about their old age security because there is only one old age security other than BPJS employment.
The affection/social needs dimension was ranked highest, with 3.41 in the high category.The attitude of the leadership, head of radiology, and radiology doctors, as well as the support of colleagues, can motivate radiology staff to be more confident.

The Influence of Organizational Culture on Radiology Staff Work Motivation
The regression coefficient result of organizational culture on radiology staff motivation is 0.483, which has a positive meaning.Calculated t value ( 3.778 ) > t Table ( 1,68 ) and the p-value is 0.00 0 ( significant),; the research results show that organizational culture directly has a positive and significant influence on the motivation of radiology staff in the XYZ Hospital Group.This means that the higher the organizational culture implemented, the greater the work motivation of radiology staff will be.
The regression coefficient of organizational culture on motivation is 0.483, more excellent than organizational culture on performance at 0.259.This means that the higher the organizational culture that is implemented, the increase in work motivation of radiology staff will be higher than the performance of radiology staff.
The results of this research align with research conducted by researchers, which stated that organizational culture has a positive and significant effect on work motivation (Putra & Dewi, 2019).Research conducted by researchers shows that organizational culture influences employees' work motivation at the Alak Health Center, Kupang City (M.Damanik et al., 2023).Research conducted by researchers shows that Islamic organizational culture positively influences Islamic work motivation (Rahman & Fuad, 2022).
Organizational culture is the shared values, principles, traditions, and ways of doing things that influence how organizational members act.

A. The Influence of Competency on Work Motivation of Radiology Staff
The results of the competency regression coefficient on radiology staff motivation were 0.390, which was positive.Calculated t value ( 2.913 ) > t Table ( 1,68 ), and the p-value is 0.002 ( significant).Thus, the research results show that competence directly has a positive and significant influence on the motivation of radiology staff in the XYZ Hospital Group.
The regression coefficient of competence on motivation is 0.390, more significant than organizational culture on performance of 0.328.This means that the higher the competency applied, the increase in work motivation of radiology staff will be higher than the performance of radiology staff.
The results of this research align with research conducted by researchers.The analysis shows a positive and significant relationship between competence and employee work motivation (Triyanto & Sudarwanti, 2014).This shows that high competence and significant commitment from employees will be able to increase employee work motivation.It was stated in research conducted by researchers that there is a link between competency in career levels and nurse motivation (Twistiandayani et al., 2020).The results of research conducted by researchers show that the competency variable has a significant positive effect on work motivation (Herlambang et al., 2018).The research results conducted by researchers show that competence and supervision competency positively and significantly affect employee achievement motivation (Darwina et al., 2019).According to research conducted by researchers competence significantly affects employee motivation (Mardiana et al., 2021).

The Influence of Organizational Culture on Radiology Staff Performance through Motivation as Mediation
The estimated parameter of organizational culture on staff performance through motivation shows significant results with a calculated t value (2.657) > t Table ( 1, 68 ) with a significance level of 0.004 <0.05 (5%), thus the research results show that motivation can be a mediating influence Organizational culture on the performance of radiology staff at XYZ Hospital Group.This means that organizational culture can indirectly influence performance through motivation.The results of this research show that organizational culture has a direct influence on the performance of radiology staff but also an indirect influence on performance through motivation.
The results of this research are in line with research conducted by researchers.The research results found that motivation plays a significant role in connecting the influence of organizational culture on employee performance (Pane, 2019).Research conducted by researchers showed that motivation can mediate between organizational culture and employee performance (Erika Febianasari & Kustini, 2022).Research conducted by researchers concluded that work motivation plays a role in mediating the influence of organizational culture on employee performance (Tecoalu et al., 2022).Researchers stated that a solid organizational culture, such as openness of information and participation of all organizational members in achieving organizational goals, can continue to be developed.When work motivation increases, it encourages employees to improve the quality and timeliness of their work (Putra & Dewi, 2019).

The Influence of Competency on Radiology Staff Performance through Motivation as Mediation
The parameter estimation of competence on staff performance through motivation shows significant results with a calculated t value (2.278) > t Table ( 1,68 ) with a significance level of 0.012 <0.05 (5%), thus the research results show that motivation can mediate the influence of competence on the performance of radiology staff in the XYZ Hospital group.This means that competence can indirectly influence performance through motivation.This research's results align with researchers research that work competency and motivation must be managed well to obtain good results from nurse performance (Halawa et al., 2020).Based on research conducted by researchers, motivation can mediate the influence of competence on employee performance (Rochmah & Suhartono, 2022).The results of research conducted by researchers resulted in motivation mediating the influence of organizational culture on the performance of employees at the Alak Health Center, Kupang City (M.Damanik et al., 2023).The results of researchers research show that motivation is a variable that fully mediates the relationship between competence and performance (Agustine Pariesti et al., 2022).The results of research conducted by researchers show that work motivation mediates the influence of employee competence on employee performance (Huda & Abdullah, 2022).Implementing the Performance Improvement Evaluation Model Based on Organizational Culture, Competency, and Work Motivation in the XYZ Hospital Group.
From field data through the performance assessment form that has been used, performance assessment variables include integrity, professionalism, commitment, trust, and compassion, which are part of corporate values.
Integrity is being honest and truthful, doing the right thing even if it is unpopular or nobody is looking, taking responsibility, including admitting mistakes and being consistent in how one acts.Description of professionalism is the desire for personal learning, self-development, courage to act as the situation requires, making quality decisions, and being customer-oriented.The description of commitment is caring that you fulfill your obligations and motivation to see the tasks/actions completed.Punctuality in meeting the timelines and prioritizing tasks/time to meet committed deadlines.The description of trust is maintaining confidentiality, trusting others, being trustworthy, and avoiding conflicts of interest.The description of compassion is caring about and understanding others, being sympathetic to others less fortunate, and listening with your heart.The performance assessment model above comes from the HRD department, which is based on corporate or company values as the leading guide for all departments, both internal and external processes.According to researchers, having performance assessments, both directly and indirectly, can improve work performance (Sedarmayanti, 2017).According to researchers, performance appraisal has the benefit of performance improvement, allowing staff and department heads to take appropriate action related to improving performance.A good performance appraisal reflects the work being assessed.Performance appraisal encourages workers to be better and identify and improve declining performance.Performance appraisal requires measurement and analysis standards according to the job.(Elmi, 2018).
Based on the opinions of the experts above, the author created a performance assessment form based on organizational culture, competency, and motivation, which has a limited scope covering only the radiology department so that the results of the performance assessment are expected to be more objective and optimal without straying from the company's goals.The performance assessment sheet can be seen in Figure 1

CONCLUSION
Based on the research and discussion above, it can be concluded that the regression coefficient of organizational culture on the performance of radiology staff is 0.259, which is positive.The t value (2.349) > t table (1.68 ), and the p-value is 0.010 (significant).Thus, organizational culture influences the performance of radiology staff positively and significantly.The results of the competency regression coefficient on the performance of radiology staff were 0.328, which was positive.The t value (3.574) > t table (1.68 ), and the p-value is 0.000 (significant).Thus, competency influences the performance of radiology staff positively and significantly.The regression coefficient result of motivation on the performance of radiology staff is 0.453, which has a positive meaning.The t value (3.833) > t table (1.68 ), and the p-value is 0.000 (significant).Thus, motivation influences the performance of radiology staff positively and significantly.The regression coefficient result of organizational culture on radiology staff motivation is 0.483, which has a positive meaning.The t value (3.778) > t table (1.68 ) and the p-value is 0.000 (significant).Thus, organizational culture influences the work motivation of radiology staff positively and significantly.The results of the competency regression coefficient on radiology staff motivation were 0.390, which was positive.The t value (2.913) > t table (1.68 ), and the p-value is 0.002 (significant).Thus, competence influences the work motivation of radiology staff positively and significantly.The estimated parameter of organizational culture on staff performance through motivation shows significant results with a value of count (2.657) > Table (1.68 ) with a significance level of 0.004 <0.05 (5%); motivation can mediate the relationship between organizational culture and radiology staff performance.The parameter estimating competency on staff performance through motivation shows significant results with a value of count (2.278) > Table (1.68 ) with a significance level of 0.012 <0.05 (5%).Thus, motivation can mediate the relationship between competency and the performance of radiology staff.Recommendations for implementing a model for improving radiology staff performance evaluation using the rating scale method with an individual target of 80% and a corporate value of 20%.Targets are taken based on indicators for each exogenous and endogenous variable.

Figure 1 .
Figure 1.Radiology Staff Performance Evaluation Sheet