DETERMINANT OF REINFORCEMENT EMPLOYEE PERFORMANCE IN MEDICAL RECORD INSTALLATION WITH MOTIVATION AS INTERVENING VARIABLE

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1 DETERMINANT OF REINFORCEMENT EMPLOYEE PERFORMANCE IN MEDICAL RECORD INSTALLATION WITH MOTIVATION AS INTERVENING VARIABLE Saryadi 1 and Istiyawati Rahayu Duta Bangsa of University, Surakarta, Indonesia. saryadi@udb.ac.id, Istiyawati_wati@gmail.com Abstract : The hospitals in Indonesian, for up the standart acreditation must be performance is good. The purpose of this study was to examined and analyzed direct and indirect effect empowerment, self-efficacy and organizational commitment on reinforcement employee performance in medical record installation through motivation. Explanative design used in this research. The population is employees in medical record installation of Dr. Moewardi Hospitals (RSDM), sample was conducted survey, is determined so much 80 respondents. Data analyzed used instrument test, partial test, simultaneously test, sobel test, R square, path analysis and correlation assisted with application software SPSS for Windows version The result show 1) self-efficacy and organizational commitment have a positive significant effect on motivation; empowerment have a positive INsignificant ) empowerment, self-efficacy and organizational commitment with motivation as an intervening variable proved to have a positive and significant effect on reinforcement employee performance in medical record installation with the contribution of R total = 70,83%. Keywords: Empowerment, Self-efficacy, Organizational Commitment, Motivation, Performance. INTRODUCTION Early programme for e-claim in Indonesian, verification in office (VEDIKA) started in year 016. Human resource in medical record installation, is brain ware management challenge and exploiting for aplication electronic claim of verification in office (VEDIKA) BPJSK go to the electronic claim (e-claim) at year 00. Empowerment quality of human resource in medical record installation and stakeholder in hospitals are owning important role in applying VEDIKA with electronic claim (e-claim) in Indonesian. The Hospital as institution of health service very have competence the good performance materialization, transparancy, akuntability, responsiveness and clear of all kind of mistake. The concept of empowerment according to Thomas & Velthouse (1990), Sumual (014) as the increase in intrinsic task motivation. According to Sumual (014), if an organization run empowerment, the organization will grow into a feeling of being 33

2 confident. Steadier organization because employees full confidence. Its increasing employees performance. Appraisal employee self-efficacy with indicator enactive mastery experience, vicarious experience, verbal persuasion, dan emotional arousal. Efficacy affect the amount of stress, individuals experience as they engage in an activity. Strong selfefficacy will produces well-being in many ways. Self-efficacy is assessment to own self from a officer in experiencing its work. Self-efficacy is related with increased individual and organizational performance (Bandura, 1997; Behjat & Chowdhury, 01). According to Olusola (011) self-efficacy, intrinsic motivation and job satisfaction will predict the job performance of industrial workers. Performance is the process of reaching an end-that is, organizational goals. According to Hung et al (018) Organizational Commitment targets for the members of the organization recognized organizations, values and beliefs; the organization is willing to invest for the effort put into the organization, and there remain on the idea organizations. According to Ahmad et al (010) organizational commitment is actively involved in the organization. Memili et al (013) defined organizational commitment is an emotional attachment to the organization, the obligation to remain within the organization. Motivation is a forces that cause peoples to be engaged in a behavior. Study by Kusworo et al (015) show more stronger the motivation is increasing the performance of educators. Kasim et al (016) shows motivational influence on the performance of the administrative staff in hospitals Abepura. LITERATURE REVIEW Employee empowerment used in assisting an organization to achieve its goals (Demirci & Erbas, 010). Empowerment can also gives growth support through career planning, rewards and welfare. According Dizgah et al (011) empowerment can influence on improve development and organizational effectiveness. Empowerment is also defined as the process of enabling and authorizing individuals to think, behaves, take action and decision and control work autonomously Rajalingam & Jauhar (015). Kondalkar (009) depict process empowerment on this figure. 34

3 Personal empowerment Proof empowerment Employees to feel safe Risc acceptance Figure 1: Empowerment Process Source: Koldakar (009), Dizgah (011). Self-efficacy is assessment to ownself in experiencing work becoming duty burden. Bandura (1977) defines self-efficacy as a person s beliefs in his or her ability to organize and execute a required course of action to achieve a desired result. Efficacy beliefs influence the amount of stress and anxiety individual experience as they engage in an activity. Sibuea & Rustono (015) used 4 indicator from Jones (1986) shows self-efficacy do not far different from told by Bandura, shows this figure. Figure : Procentage self-efficacy of employee Source: Sibuea & Rustono (015) Organizational Commitment targets for the members of the organization recognized organizations, values and beliefs; the organization is willing to invest for the effort put into the organization, and there remain on the idea organizations. According to Ahmad et al (010) that organizational commitment is actively involved in the organization, individual organizations are willing to dedicate their effort, and it is not only in thoughts and beliefs of the members of the organization, which is also reflected in the behaviour. Sriekaningsih & Setyadi (015) defined organizational commitment is as a situation in which one employee favoring certain organizations as well as the objectives and the desire to maintain membership in the organization. According to Wursanto ( 010: 30) motivation represent the motivation, desire, ambition, and mainspring coming from within self human being to something. 35

4 Motivate important progressively because to be done better and integrated to wanted target. Reinforcement can done be: 1) Responsibility, ) ready to challenge and innovation, 3) learning and adaptive, 4) dedication and commitment, 5) self-discipline and have creativity, 6) developing supertim non superior, and 7) better fox mindset. Employee performance appraisal is a process, often combine both written and oral elements, whereby management evaluates and provides feedback on employee job performance, including steps to improve or redirect activities as needed. According to Kats (005) performance as goal accomplishment. Appraisals performance in medical record installation is also important to help staff of medical record members improve their performance to working. The conceptual model and dimensions used this study, have been identified in the hypothesis. Figure 3 shows the conceptual model. Empowerment H 6 H 1 H 5 Self-efficacy H H 3 Motivation H 8 Employee Performance of Medical Record Organizational Commitment H 7 H 4 H 9 Figure 3: Conceptual model of research Source: Hady et al (017), Hasbullah & Moeins (017) METHODS This study is explanatory, aims to explain how one variable affects or is responsible for changes in other variables (Cooper and Schindler, 011: 141). Population in this study is employees in medical record installation of Dr. Moewardi Hospital Surakarta. The sampling is determined as 80 respondents by using a survey. The analysis method used in this study are questionnaire test, linearity test, partial test, simultaneously test, sobel test, and path analysis. 36

5 RESULTS AND DISCUSSION This study used path analysis with sobel test, by the following equation: Path 1: Motiv= β 1 Emp + β Self + β 3 Comm + 1 Path : Perform= β 5 Emp + β 6 Self + β 7 Comm + β 8 Motiv + To know the influence of intervening variable used formula sobel test. Sab = b S a a S b S a S b t hitung = If result t counted > t table, so there is any influence of independen variable on dependen variabel with motivation as an intervening variable The test results are as follows: Hypothesis Model 1 To see the influence of empowerment, self-efficacy and organizational commitment variables on motivation in a combined, visible results of the calculations is in the model summary, particularly the numbers of R square as the table below: Table 1 Result of R Square (R ) Model 1 Model Summary Std. Error of the Estimate Model R R Square Adjusted R Square 1,581 a,337,311,351 a. Predictors: (Constant), Comm, Self, Emp Source: Data Processing, 018. The value of R square is 0,337. The figures are intentions that empowerment, selfefficacy, and organizational commitment variables influence on motivation in a combined was 33,7%, while the remaining 66,3% influenced by other variables. Furthermore, F test results can be explained in Table below. 37

6 Table F Test Result Model 1 ANOVA b Model Sum of Squares df Mean Square F Sig. 1 Regression 13, ,71 1,897,000 a Residual 419, ,56 Total 633, a. Predictors: (Constant), Comm, Self, Emp b. Dependent Variable: Motiv Source: Data Processing, 018. Based on Table, obtained figures amounted to F hie 1,897> F tabie,7 and its significance figure of 0.000<0.05 indicates that together there is a linear relationship between the variables of empowerment, self-efficacy and organizational commitment on motivation variables. To see the influences of empowerment, self-efficacy and organizational commitment on motivation, t test was used to pay attention to where the standardized coefficient as the following table 3. Table 3 t test Result Model 1 Coefficients a Unstandardized Coefficients Standardized Coefficients Model B Std. Error Beta t Sig. 1 (Constant) 14,76 4,180 3,415,001 Emp,098,079,14 1,4,18 Self,786,56,33 3,077,003 Comm,305,143,57,13,036 a. Dependent Variable: Motiv Source: Data Processing, 018. Empowerment generate value t counted 1,4 < t table =1,99 with significant value 0,18>0.05 means there is a linear relationship between empowerment and motivation. The value of the influence of empowerment on motivation equal to 0,14 or 14,%. Empowerment have a positive but insignificant effect on motivation. Self-efficacy generate value t counted 3,077 > t table =1,99 with significant value 0,003<0.05 means there is a linear relationship between self-efficacy and motivation. The value of the influence of self-efficacy on motivation equal to 0,33 or 3,3%. Self-efficacy have a positive and significant effect on motivation. 38

7 Furthermore, for organizational commitment value t counted,13 > t table =1,99 with a significant value of <0.05 means there is a linear relationship between organizational commitment and motivation. The value of the influence of organizational commitment on motivation equal to 0,57 or 5,7%. Organizational commitment have a positive and significant effect on motivation. The research generates multiple linear regression in path 1 equation: Motiv = 0,14 Emp + 0,33 self + 0,57 Comm + e 1. The interpretation of the regression equation is, if the variable empowerment is increased by 1 unit, while self-efficacy and organizational commitment variables assumed to be constant, then the motivation will be increased by 0,14. If the variable self-efficacy is increased by 1 unit, while empowerment and organizational commitment variables assumed to be constant, then the motivation will be increased by 0,33. Conversely, if the variable organizational commitment is increased by 1 unit, while the variable empowerment and self-efficacy assumed to be constant, then the motivation will be increased by Results of regression test showed positive results in the three variables, so that the effect of a given empowerment, self-efficacy and organizational commitment run in line with variations in the motivation. Empowerment Self-efficacy P 1 =0,14 P =0,33 Motivation Organizational Commitment P 3 =0,57 F counted =1,8 9 Figure 1: Result Model 1 Hypothesis Model To see the influence of empowerment, self-efficacy, organizational commitment and motivation variables on employee performance in medical record installation in a combined, visible results of the calculations is in the model summary, particularly the numbers of R square as the table below: 39

8 Table 4 Result of R Square (R ) Model Model Summary Model R R Square Adjusted R Square Std. Error of the Estimate 1,749 a,560,537 1,719 a. Predictors: (Constant), motiv, emp, self, comm Source: Data Processing, 018. The value of R square is 0,560. The figures are intentions that empowerment, selfefficacy, organizational commitment and motivation variables influence on employee performance in medical record installation RSDM in a combined was 56,0%, while the remaining 44,0% influenced by other variables. Furthermore, F test results can be explained in Table 5 below. Table 5 F Test Result Model ANOVA b Model Sum of Squares df Mean Square F Sig. 1 Regression 8, ,614 3,906,000 a Residual 1,533 75,954 Total 503, a. Predictors: (Constant), motiv, emp, self, comm b. Dependent Variable: Perform Source: Data Processing, 018. Based on Table 5, obtained figures amounted to F hie 3,906> F tabie,7 and its significance figure of 0.000<0.05 indicates that together there is a linear relationship between the variables of empowerment, self-efficacy, organizational commitment and motivation on employee performance in medical record installation. To see the influences of empowerment, self-efficacy, organizational commitment and motivation on employee performance in medical record installation, t test was used to pay attention to where the standardized coefficient as the following table 6. 40

9 Table 6 t test Result Model Coefficients a Model Unstandardized Coefficients Standardized Coefficients t Sig. B Std. Error Beta 1 (Constant) -3,953 3,8-1,04,3 Emp,17,058,06,176,033 Self,589,198,71,97,004 Comm,6,108,13,094,040 Motiv,53,084,83 3,01,004 a. Dependent Variable: Perform Source: Data Processing, 018. Empowerment generate value t counted,176> t table =1,99 with significant value 0,033<0,05 means there is a linear relationship between empowerment and employee performance in medical record installation of RSDM. The value of the influence of empowerment on employee performance in medical record installation equal to 0,06 or 0,6%. Empowerment have a positive and significant effect on employee performance in medical record installation of RSDM. Self-efficacy generate value t counted,97> t table =1,99 with significant value 0,004<0.05 means there is a linear relationship between self-efficacy and employee performance in medical record installation of RSDM. The value of the influence of self-efficacy on employee performance in medical record installation equal to 0,71 or 7,1%. Selfefficacy have a positive and significant effect on employee performance in medical record installation of RSDM. Organizational commitment generate value t counted,094> t table =1,99 with significant value 0,040<0.05 means there is a linear relationship between organizational commitment and employee performance in medical record installation of RSDM. The value of the influence of organizational commitment on employee performance in medical record installation equal to 0,13 or 1,3%. Organizational commitment have a positive and significant effect on employee performance in medical record installation of RSDM. Furthermore, for motivation value t counted 3,01> t table =1,99 with a significant value of 0,004 <0,05 means there is a linear relationship between motivation and employee performance in medical record installation of RSDM. The value of the influence of motivation on employee performance in medical record installation equal to 0,83 or 8,3%. Motivation have a positive and significant effect on 41

10 employee performance in medical record installation of RSDM. The research generates multiple linear regression in path equation: Perform = 0,06 Emp + 0,71 self + 0,13 Comm + 0,83 Motiv + e. The interpretation of the regression equation is, if the variable empowerment is increased by 1 unit, while self-efficacy, organizational commitment and motivation variables assumed to be constant, then the employee performance in medical record installation of RSDM will be increased by 0,06. If the variable self-efficacy is increased by 1 unit, while empowerment, organizational commitment and motivation variables assumed to be constant, then the employee performance will be increased by 0,71. If the variable organizational commitment is increased by 1 unit, while empowerment, self-efficacy and motivation variables assumed to be constant, then the employee performance will be increased by 0,13. Conversely, if the variable motivation is increased by 1 unit, while the variable empowerment, self-efficacy and organizational commitment assumed to be constant, then the employee performance will be increased by 0,83. Results of regression test showed positive results in the four variables, so that the effect of a given empowerment, self-efficacy, organizational commitment and motivation run in line with variations in the employee performance in medical record installation. Empowerment Self-efficacy Motivation P 6 =0,71 P 5 =0, 06 P 8 =0,83 Employee Performance of Medical Record Organizational Commitment P 7 =0,13 F counted =3,90 6 Figure : Result Model Sobel Test (Model 3) Influence of empowerment on employee performance Installation RSDM with motivation as an intervening variable. in Medical Record 4

11 Sab = (0,53) (0,079) + (0,098) (0,084) + (0,079) (0,084) Sab = 0,06 0,53x 0,098 0,048 t counted = 1, 097 0,06 0,06 Value t counted equal to 1,097< t 80 table=1,990; There is not any influence of empowerment on Employee Performance in Medical Record Installation RSDM with motivation as an intervening variable. Influence of self-efficacy on Employee Performance Installation RSDM with motivation as an intervening variable. in Medical Record Sab = (0,53) (0,56) + (0,786) (0,084) + (0,56) (0,084) Sab = 0,095 0,53x 0,786 0,199 t counted =, 094 0,095 0,095 Value t counted equal to,094 > t 80 table=1,990; There is any influence of self-efficacy on Employee Performance in Medical Record Installation RSDM with motivation as an intervening variable. Influence of organizational commitment on Employee Performance in Medical Record Installation RSDM with motivation as an intervening variable. Sab = (0,53) (0,143) + (0,305) (0,084) + (0,143) (0,084) Sab = 0,0459 0,53x 0,305 0,77 t counted = 1, 68 0,0459 0,0459 Value t counted equal to 1,68 < t 80 table=1,990; There is not any influence of self-efficacy on Employee Performance in Medical Record Installation RSDM with motivation as an intervening variable. Coeffisien Determination Total Value of R square 1 equal to 0,337; e 1 = 1 R 1 = 1 0,337 = 0, 663 = 0,814 Value of R square 1 equal to 0,560; e = 1 R = 0,560 1 = 0, 440 = 0,6633 R total = 1 (e 1 x e ) = 1 (0,663 x 0,440) = 1-0,917 = 0,

12 R total equal to 0,7083; its meaning reinforment employee performance in medical record installation RSDM explained empowerment, self-efficacy and organizational commitment through motivation equal to 70,83%; so the rest equal to 9,17% explained another dissimilar factor outside a model. Direct and Indirect Effect Table 7 Direct and Indirect Effect Effect Variable Relation Direct Indirect Empowerment 0,17 performance Self-efficacy 0,589 performance Organizational commitment 0,6 performance Empowerment P 1 x P 5 = motivation performance 0,098 x 0,53 = 0,05 Self-efficacy motivation P 1 x P 5 = performance 0,786 x 0,53= 0,199 Org. commitment P 3 x P 5 = motivation performance 0,305 x 0,53 = 0,077 Source: processing data, 018 Total Effect P 4 + (P 1 x P 7) = 0,17 + 0,05 = 0,15 P 4 + (P 1 x P 7) = 0, ,199 = 0,788 P 6 + (P 3 x P 7) = 0,6 + 0,077 = 0,303 Direct effect self-efficacy variable on Employee Performance in Medical Record Installation RSDM is efectively and dominant for reinforcement employee performance in medical record installation RSDM. CONCLUSION The result show The result show 1) empowerment, self-efficacy and organizational commitment have a positive significant effect on motivation; ) empowerment, selfefficacy and organizational commitment with motivation as an intervening variable proved to have a positive and significant effect on reinforcement employee performance in medical record installation with the contribution of R total = 70,83%. 1) empowerment parsial has a positive but insignificant effect on motivation; ) selfefficacy have a positive and significant effect on motivation; 3) organizational Commitment have a positive and significant effect on motivation 4) empowerment and self-efficacy together proved have a positive and significant effect on 44

13 organizational Commitment in medical record installation of RSDM with the contribution of R = 33,7%, and a significance level of F counted 1,897 with significance of <0.05; 5) empowerment have a positive and significant effect on reinforcement employee performance in medical record installation of RSDM, 6) self-efficacy have a positive and significant effect on reinforcement employee performance in medical record installation of RSDM, 7) organizational Commitment have a positive and significant effect on reinforcement employee performance in medical record installation of RSDM, 8) motivation have a positive and significant effect on reinforcement employee performance in medical record installation of RSDM, 9) empowerment, self-efficacy and organizational Commitment together proved have a positive and significant effect on reinforcement employee performance in medical record installation of RSDM with the contribution of R = 56,0%, and a significance level of F counted = 3,906 with significance of <0.05; 10) empowerment has a positive and significant effect on reinforcement employee performance in medical record installation of RSDM with motivation as mediation; 11) self-efficacy has a positive and significant effect on reinforcement employee performance in medical record installation of RSDM with motivation as mediation; 1) organizational Commitment has a positive and significant effect on reinforcement employee performance in medical record installation of RSDM with motivation as mediation. Furthermore, empowerment, self-efficacy and organizational Commitment together proved to have a positive and significant effect on reinforcement employee performance in medical record installation of RSDM with the contribution of R total = 70,83%. Self-efficacy is the dominant variable affecting on reinforcement employee performance in medical record installation of RSDM. 45

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