The Effect of Communication, Motivation, and Work Stress on the Performance of Hospital Employees

During the COVID-19 pandemic RSD. dr. Soebandi is the primary referral hospital, so it is required to provide excellent service, supported by 1049 employees, consisting of 435 nurses, 108 doctors, 277 administrative staff, and 229 other staff. However, the results of initial observations show that the performance of hospital services still does not meet the target achievement standardized by the RSD. dr. Soebandi himself and national realization standards. This research was conducted in the inpatient room of the RSD. dr. Soebandi with a population of 208 respondents with a sample of 137 respondents. The results showed that partial communication positively affects employee performance of tcount 2,430. There is a partial influence between motivation on performance of tcount 2.776. There is a partial effect between work stress on employee performance of tcount 4,290 at a significance level of 0.000. At the same time, the simultaneous influence of communication, motivation, and work stress affects the performance of RSD employees. dr. Soebandi. So it can be concluded that the research results have a positive and significant influence both partially and simultaneously, so the hypothesis is accepted.


INTRODUCTION
A hospital is a form of a health service organization that plays a vital role in improving public health and is an essential element of the health care system with various types of services provided to patients. The success of health services in hospitals cannot be separated from various factors, one of which is the human resource factor. Good management in managing human resources becomes the principal capital in achieving organizational goals. Hasibuan (2020:10) said that human resource management is the science and art of regulating the relationship and role of the workforce to be effective and efficient in helping the realization of the goals of the company, employees, and society. Human resources are seen as organizational assets, even an organizational investment, if these human resources are skilled and reliable.
During the COVID-19 pandemic, with the number of patients continuing to increase, RSD. dr. Soebandi is the main referral hospital in Jember Regency, so it is required to provide excellent service, supported by 1049 employees, consisting of 435 nurses, 108 doctors, 277 administrative staff, and 229 other staff. However, the results of initial observations at the end of 2021 by looking at the data in the RSD. dr. Soebandi hospital's service performance still does not meet the target achievement standardized by the RSD. dr. Soebandi himself and national realization standards. From the table above it can be seen that the average target attainment score is good, but the service quality indicators are assessed. There are several indicators that do not reach ideal parameter values, including the first BOR (Bed occupancy rate). The measurement results are said to be good if the percentage figure reaches 65-80%, achievement of the BOR (Bed occupancy rate ) in RSD. dr. Soebandi shows a percentage of 50.36%, which means that 14.64% is still lacking in order to get good results. The two GDR measurement results based on national standards are said to be good if not more than 45%, but the percentage achievement obtained was 103.61%, this was due to the Covid-19 pandemic which caused the BOR to not be up to standard because several rooms could not operate optimally. The GDR rate is very high because many Covid referral patients arrive in severe condition. This is also caused by the low awareness of the community to utilize health services if they experience health problems. The public is afraid that the hospital will make non-covid 19 patients positive for covid.
Employee performance must be considered in hospital services because it is one aspect that plays a vital role in improving service performance. According to Edison (2018: 188), performance results from a process that refers to and is measured within a certain period based on pre-determined provisions and agreements. Several efforts to develop human resources or improve performance required factors can affect performance. According to Scott in Begia (2015), factors that affect performance include communication and work motivation. First, according to Mangkunegara (2017:145), communication is transferring information, ideas, and understanding from one person to another, which can be interpreted according to the intended purpose. Another opinion about the notion of communication, according to Robbins (2018:223) communication is a stage between the source (transfer) and the recipient (understanding). Because communicating is not just conveying information, but the information must be able to be understood by the recipient of the information. The second motivation, according to Sondang P. Siagian in Hasibuan (2019: 95), Work motivation is a driving force that causes an employee to be willing and willing to move the ability to form expertise and skills, energy and time to carry out various activities that are their responsibility and fulfil their obligations in carrying out their duties. Order to achieve the company's goals and objectives that have been previously determined. Mangkunegara (2017:76) states that There is a positive relationship between motivation and performance achievement. This means that employees with high motivation will achieve high performance and vice versa. If the motivation is low, it will perform low. According to Wibowo (2017: 187), stress can impact employee performance and should concern organizations, managers, and workers. Based on this background, researchers are interested in researching the effect of communication, motivation, and work stress on employee performance during the covid 19 pandemic Partially or simultaneously.

METHOD
This research was conducted in RSD. dr. Soebandi, Jember Regency, especially in the inpatient department with a population of 208 employees with a total sample of 137 employees. In this study, the method used in sampling using the slovin formula. Then, determining the sample/respondent is done by random sampling, where to determine the respondent is done randomly. This study's types of data sources are primary data in the form of questionnaires and observations. At the same time, secondary data is in the form of documentation of research activities. Data collection techniques in this study used questionnaires, observations, literature studies, and documentation. The data processing stage is data checking, coding, and tabulation. The research instrument in this study was a questionnaire in the form of questions using a Likert scale of 1-5 as a measurement scale. The instrument test in this study used validity and reliability tests. At the same time, the test analysis in this study uses multiple linear regression analysis. The conceptual framework model in this study is as follows:

RESULT AND DISCUSSION Test Instrument
The results of the validity and reliability tests show, it is known that each indicator (item) in the variables used has a Pearson's product moment value with a significance of 0.000 < 0.05, so the indicators (items) used in this research variable can be declared appropriate or relevant. They can be used. as items in data collection. the results of the reliability test above show that the data obtained are reliable because the Cronbach's Alpha values are 0.750, 0.864, 0.706, and 0.636 > 0.60, so the data obtained can be declared reliable or feasible as a tool in data collection. Figure 2 shows that the data is normally distributed because the data spread around the diagonal line and follows the direction of the diagonal line so that it can be stated that the regression model fulfils the assumption of normality. There is no multicollinearity Source: processed data Table 2 shows that there is no multicollinearity between independent variables because it shows the VIF value is less than 10. Figure 3 shows no heteroscedasticity because the data spread does not form a particular line, or there is no clear pattern, and the points spread above and below zero on the Y axis.. Sig. F = 0,000 Source: processed data Based on the regression coefficient, the regression equation that can be formed is; ; Y = 0,801 + 0,203X1 + 0,242X2 + 0,322X3

The effect of motivation on employee performance
The testing and analysis results show that motivation has a positive and significant effect on the performance of RSD employees. dr. Soebandi's research conducted shows that the coefficient value of the work motivation variable is 0.242 or 24.2% in a positive direction. If the motivation variable (X2) increases, the employee performance variable (Y) also increases. Meanwhile, if the motivation variable (X2) has decreased, the employee performance variable (Y). The study by Yeti (2020) shows that motivation is empirically proven to have a strong and positive effect on employee performance.

The effect of work stress on employee performance
The results of testing and data analysis of the research carried out showed that the coefficient value of the Work Stress variable had a positive effect on the performance of RSD dr. Soebandi shows that the coefficient value of the work stress variable is 0.322 or 32.2% in a positive direction. Based on the results of interviews conducted with RSD employees. dr. Soebandi stated that the stress felt by employees is not an obstacle in doing work, but it is considered a challenge and motivation to improve performance further. In addition, the high responsibility received by employees is in line with the compensation received. This is then deemed able to encourage employees to continually work harder so that it has an impact on increasing performance. In this case, it can be interpreted that the stress felt by employees can be adequately managed so that it becomes motivation. According to Berney and Selye (in Dewi 2012:107), there are four types of stress, one of which is Eustress (good stress) is stress that causes stimulation and excitement so that it has a beneficial effect on individuals who experience it, for example, challenges that arise from increased responsibility, time pressure, and high-quality assignments. This study's results align with research conducted by Ilham (2022). The results of the study show that work stress affects employee performance. Different from the research conducted by Hotiana et al. (2018), the results of the study state that work stress has no significant effect on performance.

CONCLUSION
Based on the analysis carried out in this study, the following conclusions can be drawn; first, communication affects the performance of employees in RSD dr. Soebandi is in a positive direction. This proves that increased work communication will increase employee performance; secondly, work motivation affects employee performance in RSD dr. Soebandi is in a positive direction. This proves that increasing work motivation among employees will improve employee performance; thirdly, work stress affects the performance of employees at RSD dr. Soebandi is in a positive direction. This proves that increasing work stress in individual employees will increase the completion of work or employee tasks and increase overall work; RSD employees feel work stress. dr. Soebandi is not an obstacle in doing work. Fourth, communication, work motivation, and stress simultaneously affect employees' performance at RSD dr. Soebandi is in a positive direction. This proves that good communication between employees, increasing work motivation and stress, and completion of work that has been charged will influence employee performance.