The Influence Of Work Culture And Work Discipline On Employee Performance At Advent Hospital Medan

. Hospital performance is very important to ensure that patients get the right care according to their needs. Hospital performance is also very important to ensure that hospitals can carry out their functions properly and efficiently, and are able to provide quality services to patients. This study aims to determine the effect of culture and work discipline on employee performance. This research was conducted at the Medan Adventist Hospital with a sample of 100 hospital employees. The results of the study show that the contribution of organizational citizenship behavior and social intelligence to performance is 72.0% so that a high work culture and discipline improve employee performance so that it motivates employees to work. Disciplined behavior will lead to productivity and end in performance.

http://ijstm.inarah.co.id 1341 Discipline is the most important operative function of Human Resource Management, because the better the work discipline , the higher the work performance that can be achieved.Without good employee discipline, Without good employee discipline, it is difficult for hospitals to achieve optimal results (Hasibuan, 2019 ) .Work discipline is employee compliance or obedience to applicable rules (Hasibuan, JS & Silvya, 2019).Work discipline is very important in a hospital because without discipline, every job will not be completed properly (Muamar, 2017).Work discipline is a conscious attitude or willingness of an employee to carry out and obey the rules set by the hospital.With this, it will encourage morale, and encourage the realization of hospital goals.Employees with high morale feel that they are involved in the goals of the hospital and deserve attention that their efforts are appreciated and recognized.So that employees with high enthusiasm give positive attitudes such as loyalty, joy, cooperation, pride and obedience to their obligations.The employee work discipline is taken from the average monthly absences in 1

Source: Medan Adventist Hospital 2021
Based on monthly attendance data for 1 year of employee work at the Medan Adventist Hospital March 1 2021-February 1 2022 in table 1.2 it can be seen that the Medan Adventist Hospital has employee absence data every month there are still employees who are absent from March 2021 to February 2022, only during May and December will it be fully present or called Nil with 100 employees.Based on the results of observations at the location of the Medan Adventist Hospital towards employees, there are problems that occur regarding work culture, employees must attend according to their schedule and duties.The work culture of the Medan Adventist Hospital and other hospitals has a different hospital work culture, namely "I help" so all employees must be willing to help patients, so it doesn't have to be a nurse pushing a wheelchair, even a security guard is allowed.The results of a survey of 40 employees found that 40% did not comply and violated the culture of the Medan Adventist Hospital.This can be seen from employees who are late, avoid not coming to work, do not come to work according to schedule, leave work, do not do tasks given by superiors, work carelessly.careful, not careful when taking medicine and not double-checking the doctor's prescription.The results of a survey conducted by researchers through simple interviews about the employees who want to be examined are all employees at the Adventist Hospital in Medan City, obtained in the form of results through Human Resource Development (HRD) at Medan Adventist Hospital (2022) The work culture in the hospital includes creating togetherness, creating openness, being highly disciplined, and creating togetherness.
The work culture in detail at the Medan Adventist Hospital is that every employee is free to express his opinion during a meeting with the head of the Hospital and Human Resource Development (HRD) executor by giving time to ask what the employee wants to ask.And based on the interviews I've done to Human Resource Development (HRD) regarding work culture, it can be concluded that 80% of employees are indicated to be satisfied with the work culture that exists at the Medan Adventist General Hospital .The documentation of the results of the performance assessment of the Medan Adventist General Hospital based http://ijstm.inarah.co.id 1342 on the national health service measurement standards as stipulated in the Decree of the Minister of Health of the Republic of Indonesia Number 228/Menkes/SK/III/2002 concerning guidelines for the preparation of minimum service standards (SPM) for Hospitals shows that there are still several conditions poor performance.The condition of hospital performance which is included in this unfavorable category is related to employee performance.This means that if the employees and all elements in the hospital do not perform well, then this will affect the company's performance in general.Looking at the results of previous research and the opinions of several experts, it can be stated that work culture plays an important role in improving employee performance.This means that a hospital has a healthy culture that is liked by its employees, this will support employees to show optimal performance.Conversely, a work culture that is not liked by employees, this will worsen employee performance.The phenomenon related to employee performance based on the results of a Human Resource Development (HRD) survey with the initials G, that the employee performance target of 80% has met the target as well as the results of the 95% satisfied customer satisfaction survey, can be seen from the quality of employees who carry out their duties and work well, such as for employees working in the pharmaceutical section of the drug section employees clearly check again and ask for the patient's name and explain one by one how to use the correct drug so that the patient is not mistaken in taking the drug.The quantity of employees when patients come for treatment is not on time with the doctor's schedule.The patient will not be served and the patient can seek treatment again by adjusting the doctor's schedule at the Medan Adventist Hospital.Timeliness of every employee who comes is always on time, if he does not come on time, he will be subject to a sanction with salary deductions so that employees work on time.Effectiveness at Medan Adventist Hospital when patients come to register for treatment other than BPJS employees are also assisted by security guards to reduce queues so that the process of registering for treatment is fast.Independence, if there is a team of employees who cannot complete their tasks on time, another employee will work on them to complete their tasks.Work commitment, all employees work hard wholeheartedly in helping provide services to every patient who comes for treatment to provide wheelchairs to patients.The level of employee discipline is good because attendance uses face, hand and finger print sensors.Employee performance evaluation is carried out every three months after the assessment there are distribution of incentives and rewards if there are employees who are subject to warning letters (SP) not getting up to two assessments.Whereas negligence that causes a large risk of loss that exceeds the employee's salary can be subject to direct sanctions with three (three) warning letters (SP), if negligence without loss usually results in verbal warning sanctions, warning letters, one, two, three warning letters and termination of work.So that the performance expected by the leadership and the organization has been sufficiently achieved.Based on the description of the performance phenomenon of the Medan Adventist General Hospital in general it still shows poor performance, and in particular there are still some employees who have low performance and there is a theoretical influence between work culture and work discipline on employee performance with this information, that given the work culture and work discipline on employee performance is very important for the hospital, so further research is carried out, namely how much influence it has on the progress of employee performance at the Medan Adventist General Hospital.

Variable Identification
Research variables are steps to determine the main variables that are the focus of research and determine their respective functions (Azwar, 2010).
The variables that will be used in this study, namely:

Research Instruments (if quantitative research) / Data Collection Techniques (if qualitative research)
Work Culture according to a scale compiled based on aspects of work culture (Tika, 2008) which include: basic assumptions, adopted beliefs, guidelines for solving problems, sharing of values, inheritance (learning process), adjustments ( adaptation ).The higher the subject's score on the scale, the higher the work culture.Vice versa, the lower the subject's score on the scale, the weaker the work culture towards the hospital.
Table 1 Employee discipline will be measured using a scale that is based on aspects of work discipline (Robinns, 2005) including time discipline, regulatory discipline, and responsibility discipline.The higher the subject's score on the scale, the higher the work discipline.Vice versa, the lower the subject's score on the scale, the lower the work discipline.

Research subject
The subjects of this study were all employees of the non-medical department at the Medan Adventist Hospital to become research subjects, totaling 100 people.The method of determining the sample uses the purposive sampling method , which in this technique requires that the sample be taken based on criteria that have been adjusted to the research objectives or the desire for analysis in accordance with the variables to be studied.Based on data from the Medan Adventist Hospital, there are 100 non-medical employees at the Medan Adventist Hospital

Research methods
The data collection method in this study is the Likert scale method.The Likert scale is a scale used to measure the perceptions, attitudes or opinions of a person or group regarding an event or social phenomenon, based on the operational definition set by the researcher.The characteristics of the psychological scale are the stimulus in the form of statements or questions that can reveal indicators of According to Azwar (2015 ) , there are several characteristics of psychological scales, namely: 1).The stimulus is in the form of questions or statements that do not directly reveal the attributes to be measured, but reveal the behavioral indicators and attributes concerned .2).A psychological scale is only intended to reveal a single attribute.
3).Subject response is not classified as ja w bro Correct or Wrong.4).The subject is usually not aware of the direction of the desired answer and what conclusions are actually revealed by the question or statement .5).The validity of the psychological scale is more determined by the clarity of the psychological concept to be measured and its operationalization.In this study, three kinds of scales were used, namely the employee performance scale, work culture, and work discipline scale.

Employee Performance Scale
This employee performance data was compiled by the author based on the documentation of the results of measuring employee performance in accordance with the technical guidelines for filling out employee performance appraisals that apply at the Medan Adventist Hospital obtained from the Human Resources Operations Section.

Work Culture Scale
The work culture scale is compiled based on work culture aspects according to (Tika, 2008), which include: basic assumptions, adhered beliefs, guidelines for solving problems, sharing of values , inheritance ( learning process ), adjustments (adaptation).The items on the work culture scale are statements consisting of five possible answers, namely SS (Highly Appropriate), S (Appropriate), TS (Not Appropriate), and STS (Very Unsuitable).

Work Discipline Scale
The scale of work discipline is arranged based on aspects of work discipline according to (Robinns, 2005) which include time discipline, regulatory discipline, responsibility discipline.Items on the work discipline scale are statements consisting of five answer choices, namely SS (Highly Appropriate), S (Suitable), TS (Not Appropriate), and STS (Very Inappropriate).

Analysis Techniques
In this study, researchers used multiple linear regression analysis methods, which were used to test the effect of work culture and work discipline on employee performance at the Medan Adventist Hospital.This data analysis was carried out using the help of a computer application program, namely SPSS 23 for Windows .

III. RESULT AND DISCUSSION
Based on the performance scale trial data, out of 10 statements there are 9 valid items with a Corrected Item-Total Correlation score (difference power index) > 0.3; valid item scores move from rbt = 0.320 to rbt = 0.684.there is 1 item that is dropped, because the item that is dropped has a Corrected Item-Total Correlation score (difference index) <0. 3 After knowing the validity of the item then proceed with reliability analysis (reliability).The reliability index obtained by the performance scale = 0.902, meaning that the performance scale as a measuring tool is categorized as reliable.Based on trial data on the work culture scale, it shows that of the 9 statements, there are 9 valid items with a Corrected Item-Total Correlation score (difference index) > 0.3.After knowing the validity of the item then proceed with reliability analysis (reliability).The reliability index obtained by the scale is = 0.864, meaning that the work culture scale as a measuring tool is categorized as reliable.The following is a table of the distribution of items from the work culture scale after being tested: After knowing the validity of the item then proceed with reliability analysis (reliability).The reliability index obtained by the work culture scale = 0.864, meaning that the performance scale as a measuring tool is categorized as reliable.Based on trial data on the work discipline scale, it shows that out of 10 statements there are 9 valid items with a Corrected Item-Total Correlation score (difference index) > 0.3; valid item scores move from rbt = 0.304 to rbt = 0.650.there is 1 item that is dropped, because the item that is dropped has a Corrected Item-Total Correlation score (difference index) <0.3.The following is a table of the distribution of items from the work discipline scale after being tested: http://ijstm.inarah.co.id 1346 After knowing the validity of the item then proceed with reliability analysis (reliability).The reliability index obtained by the work discipline scale = 0.891, meaning that the performance scale as a measuring tool is categorized as reliable.Based on the linearity test, it can be seen whether the independent variable and the dependent variable can or cannot be analyzed by regression.The results of the analysis show that the independent variables X1 and X2 (work culture and work discipline) have a linear relationship with the dependent variable (performance).As a criterion, if p < 0.05 then it is stated to have a degree of linear relationship (Riadi, 2016).The relationship can be seen in the following table: Table 6.Linearity Test Calculation Results  Based on the curve above it can be seen that performance classified as low where the hypothetical mean (22.5) is smaller than the empirical mean (17.21) and the difference does not exceed one SD ( 2.854 ).

Fig 2. Work Culture Variable Normal Curve
Based on the curve above it can be seen that work culture classified as low where the hypothetical mean ( 15) is smaller than the empirical mean (11.44) and the difference does not exceed one SD ( 1.903 ).

Fig 3. Work Discipline Variable Normal Curve
Based on the above curve, it can be seen that work discipline is low where the hypothetical mean (22.5) is greater than the empirical mean (17.18) and the difference does not exceed one SD (3.189).

Discussion
The results of the analysis using multiple regression analysis method, it is known that there is a significant positive effect between work culture and work discipline on the performance of Medan Adventist Hospital employees.This can be seen from the results of data analysis using SPSS ( Statistics Packages For Social Science ) version 23 for Windows .The discussion will start with the relationship between the first independent variable and the dependent variable and will continue with the relationship between the second independent variable and the dependent variable, then the discussion will end with the relationship between the first and second independent variables simultaneously with the dependent variable.Based on the results of research analysis at Medan Adventist Hospital , it is known that there is a significant influence between work culture on performance seen from t count > t table with p = 0.000 <0.025, which is 4.672 > 1.660 with sig 0.000 <0.025 means there is an influence of work culture with performance the higher the work culture, the better the performance of Medan Adventist Hospital employees.out work culture activities can be seen from increasing responsibility, increasing work discipline and adherence to a rule or rule, creating more harmonious communication and interaction relationships with everyone at all levels, increasing attention and participation, increasing opportunities for problem solving.and reduced rates of complaining and loss to follow-up .In this study it can be concluded that work culture has a positive and significant influence on employee performance at Medan Adventist Hospital.This shows that with a good level of work culture it will greatly affect the level of employee performance.Based on the results of research analysis at Medan Adventist Hospital, it is known that there is a significant influence between work discipline on performance seen from t count > t table with p = 0.000 <0.025, which is equal to 7.083 > 1.660 with sig 0.000 <0.025 meaning that there is an influence of work discipline with the higher performance of work discipline, the better the performance of Medan Adventist Hospital employees.In research conducted by (Jufrizen, 2018) he concluded that there is a positive and significant influence between work discipline on employee performance.In research conducted by (Prayogi, et  But in this study it can be concluded that Work Discipline has a positive and significant influence on Employee Performance at Medan Adventist Hospital.This shows that with a good level of discipline it will greatly affect the level of employee performance.From the results of the analysis using the multiple regression analysis method, it is known that there is a significant influence of work culture and work discipline on performance seen from the coefficient value (R²) = 0.720 with p = 0.000 <0.050, Contributions given by work culture and work discipline simultaneously can be seen from the value (R²) = 0.720, which means that the contribution given by work discipline is 72.0% to the performance of the employees of the Medan Adventist Hospital.These results are also strengthened by the results of the F test, where the calculated F value > F table is 124.541> 3.090 with a significance of 0.000 <0.050.Work discipline and work culture are closely related to one another.If work discipline is not good, and work culture decreases, employee performance will also decrease.The results of this study are supported by research ( Herwanto , 2022) entitled The Influence of Work Culture and Work Discipline on Performance states that there is an influence of work culture and work discipline on employee performance.This means that the higher the work culture in the Medan Adventist Hospital and the better the work discipline of the Medan Adventist Hospital employees , the better the performance of the Medan Adventist Hospital employees .

IV. CONCLUSION AND SUGGESTION Conclusion
Culture partially has a significant effect on employee performance.Which means that if the work culture is high, then employee performance is also high.Work culture cannot be separated from employee performance at a hospital , especially at the Medan Adventist Hospital , because work culture behavior will lead to productivity and end in performance.And a high work culture and high work discipline are needed in improving employee performance at the Medan Adventist Hospital.Which means that if employees have work culture behavior, good work discipline at Medan Adventist Hospital will make employee performance even better.

Suggestion
It is expected to examine other independent variables that contribute to employee performance because the contribution of work culture and work discipline to performance is very large.So that later it will enrich the discussion on performance in various other variables.http://ijstm.inarah.co.id 1349 of the comparison of the mean or hypothetical average value with the empirical mean or average value and the standard deviation can be seen in the table below.
Fig 3. Work Discipline Variable Normal CurveBased on the above curve, it can be seen that work discipline is low where the hypothetical mean(22.5)  is greater than the empirical mean(17.18)and the difference does not exceed one SD(3.189).DiscussionThe results of the analysis using multiple regression analysis method, it is known that there is a significant positive effect between work culture and work discipline on the performance of Medan Adventist Hospital employees.This can be seen from the results of data analysis using SPSS ( Statistics Packages For Social Science ) version 23 for Windows .The discussion will start with the relationship between the first independent variable and the dependent variable and will continue with the relationship between the second independent variable and the dependent variable, then the discussion will end with the relationship between the first and second independent variables simultaneously with the dependent variable.Based on the results of research analysis at Medan Adventist Hospital , it is known that there is a significant influence between work culture on performance seen from t count > t table with p = 0.000 <0.025, which is 4.672 > 1.660 with sig 0.000 <0.025 means there is an influence of work culture with performance the higher the work culture, the better the performance of Medan Adventist Hospital employees.In research conducted by (Adha, et al 2019); (Muis, Jufrizen, & Fahmi, 2018); (Jufrizen, Lumbanraja, Salim, & Gultom, 2017) states that there is a positive and significant influence between work culture on employee performance.In research conducted by (Kusumawati, 2015); (Jufrizen, 2017); (Jufrizen, Gultom, Sitorus, Sari, & Nasution, 2018); (Jufrizen & Rahmadhani, 2020) who concluded that there is a positive and significant influence between work culture on employee performance.According to Suwanto ( 2019) Success in carrying

Table 1 .
(one) year of employee work at the Medan Adventist Hospital 01 March 2021-01 February 2022 in table 1 namely.Monthly attendance data in 1 year of employee employment at Medan Adventist Hospital 01 March 2021-01 February 2022 . Work Culture Scale Blueprint

Table 2 .
Work Discipline Scale Blueprint behavioral indicators are expressed through items, the subject's responses are acceptable as long as they are given honestly and earnestly(Azwar, 1998).This study uses a Likert scale scaling model.There are two types of statements in this scaling model, namely favorable and unfavorable .Favorable statements are positive statements that support the attitude object being disclosed.An unfavorable statement is a negative statement that does not support the attitude object to be expressed(Azwar, 2000).The scale consists of a number of items which are described into favorable and unfavorable forms with four categories of answers consisting of: SS (Highly Appropriate), S (Suitable), TS (Not Appropriate), and STS (Highly Unsuitable).The score for a favorable item if you choose a very appropriate response is 4, appropriate is 3, unsuitable is 2, and very inappropriate is 1.Conversely, the score for subjects who choose unfavorable answers if the response is very appropriate is 1, appropriate is 2, not appropriate is 3, and very inappropriate is 4.

Table 3 .
. The following is a table of the distribution of items from the Performance scale after testing: Distribution of Performance Scale Items After Test C ob a _ _ http://ijstm.inarah.co.id 1345

Table 4 .
Distribution of Work Culture Scale Items After Test C ob a _ _

Table 5 .
Distribution of Work Discipline Scale Items After Test C ob a _ _

Table 7 .
Results of Calculation of Hypothetical Mean and Empirical Mean Fig 1. Performance Variable Normal Curve al. 2019) which states that there is a positive and significant influence between work discipline on employee performance.Likewise research (Arif, et al. 2019) which concluded that discipline affects employee performance.Work discipline is employee compliance or obedience to applicable rules (Hasibuan, JS & Silvya, 2019).