Influence of organizational behavior and SIMRS on ER employees performance in dr. H. Abdul Moeloek hospital Lampung

Based on the results of the observations, the authors found that the performance of the emergency room employees at RSUD dr.H.Abdul Moeleok, Lampung Province, which was still not optimal, seen from the time that was not in accordance with the applicable SOPs so that it had an impact on the health services provided by employees. Phenomenon that occurs Organizational Behavior which is a forum for individuals, organizational structures and the environment that has not been running well is seen from individuals who have a central role who have not carried out their roles well, including in the use of available information technology as a support so that it has an impact on health services. In addition, the current Hospital Management Information System (SIMRS) is not yet comprehensive in accommodating the required transaction menu. The purpose of this study was to determine the influence of organizational behavior and Hospital Management Information System on the performance of Emergency Department employees at dr.H.Abdul Moeloek Hospital, Lampung Province, either partially or simultaneously. The sample used was 81 employees. The method of data collection uses observation, documentation and questionnaire techniques. Data analysis used a quantitative approach with the help of SPSS statistical tools with the results of validity tests, reliability tests, regression tests and coefficients of determination tests. The results of partial hypothesis testing indicate that there is an influence of organizational behavior (X}) on performance (Y) with a contribution of 82.6%. The same thing applies to the Hospital Management Information System variable (X2) on performance (Y) with a contribution of 93.7%. The results of hypothesis testing the influence of organizational behavior (X}) and Hospital Management Information System (X2) on performance (Y) simultaneously show that they have an influence with a contribution of 94.2% while the remaining 5.8% is explained by factors

Based on the results of the observations, the authors found that the performance of the emergency room employees at RSUD dr.H.Abdul Moeleok, Lampung Province, which was still not optimal, seen from the time that was not in accordance with the applicable SOPs so that it had an impact on the health services provided by employees. Phenomenon that occurs Organizational Behavior which is a forum for individuals, organizational structures and the environment that has not been running well is seen from individuals who have a central role who have not carried out their roles well, including in the use of available information technology as a support so that it has an impact on health services. In addition, the current Hospital Management Information System (SIMRS) is not yet comprehensive in accommodating the required transaction menu. The purpose of this study was to determine the influence of organizational behavior and Hospital Management Information System on the performance of Emergency Department employees at dr.H.Abdul Moeloek Hospital, Lampung Province, either partially or simultaneously. The sample used was 81 employees. The method of data collection uses observation, documentation and questionnaire techniques. Data analysis used a quantitative approach with the help of SPSS statistical tools with the results of validity tests, reliability tests, regression tests and coefficients of determination tests. The results of partial hypothesis testing indicate that there is an influence of organizational behavior (X}) on performance (Y) with a contribution of 82.6%. The same thing applies to the Hospital Management Information System variable (X2) on performance (Y) with a contribution of 93.7%. The results of hypothesis testing the influence of organizational behavior (X}) and Hospital Management Information System (X2) on performance (Y) simultaneously show that they have an influence with a contribution of 94.2% while the remaining 5.8% is explained by factors -other factors not examined in this study

A B S T R A K
Berdasarkan hasil observasi, penulis menemukan bahwa kinerja pegawai IGD RSUD dr.H.Abdul Moeleok Provinsi Lampung masih belum optimal dilihat dari waktu yang belum sesuai dengan SOP yang berlaku. sehingga berdampak pada pelayanan kesehatan yang diberikan oleh pegawai. Fenomena yang terjadi Organizational Behavior yang merupakan wadah bagi individu, struktur organisasi dan lingkungan yang belum berjalan dengan baik terlihat dari individu yang memiliki peran sentral belum menjalankan perannya dengan baik, termasuk dalam pemanfaatan teknologi informasi yang tersedia sebagai dukungan sehingga berdampak pada pelayanan kesehatan. Selain itu, Sistem Informasi Manajemen Rumah Sakit (SIMRS) yang ada saat ini belum komprehensif dalam mengakomodir menu transaksi yang dibutuhkan. Tujuan penelitian ini adalah untuk mengetahui pengaruh perilaku organisasi INTRODUCTION Regional General Hospital Dr. H. Abdul Moeleok, Lampung Province, known as RSUD Dr. H. Abdul Moeleok, is the highest reference in the procedure of health services in Lampung Province and an A Rank Teaching Hospital. Given that this Hospital is a health storefront in Bumi Ruwa Jurai, health services are of certainly provided in full. Health workers are definitely at the forefront of providing health services because they contact directly with service clients; organizational behavior is the primary factor that influences them. Furthermore, technology is the primary thing in health care, namely the Hospital Management Information System (SIMRS), which is a computer application software designed to assist hospital management in storing, processing, and preparing patient data reports.
Based on the Regulation of the Minister of Health (Permenkes) RI Number 82 of 2013 concerning Hospital Management Information Systems in the article (2), namely "SIMRS settings aim to increase efficiency, effectiveness, professionalism, performance and access and hospital services". Then in Article 2 paragraph (1) reads "Every hospital is obliged to organize SIMRS". Another article, namely Article 4 paragraph 1 states "Every hospital must carry out the management and development of SIMRS".
In its application, the Hospital Management Information System (SIMRS) is expected to be able to perform highquality data processing from all work units of the Hospital, so that later information that can be understood, comprehensive, and efficiently will be obtained in the process of providing health services. Good implementation will be able to support the management process and clinical services to be more influence and efficient, as well as minimize the occurrence of shortages of services for patients, including in terms of administration.
The key to effective SIMRS implementation in hospitals is organizational behavior, which includes health worker behavior such as dedication, compliance, and discipline. Positive behavior is required to assist the implementation of SIMRS to build influence and efficiency so that the expected outcome is that employee performance can increase effectively. On the other hand, if there is behavior that does not support the development of SIMRS implementation, an obstacle may appear or become an obstacle in its implementation, and it could even cause failure in improving the performance of health professionals.
Previous studies regarding SIMRS in several different agencies have shown that the implementation of SIMRS has an influence on performance and can improve the performance of employees in hospitals, either through system advantages or organizational capacity. However, on the other hand, problems related to organizational behavior in the implementation of SIMRS have not been discussed much.
Related to the performance of the SOP for the Emergency Room at RSUD dr. H. Abdul Moeloek Lampung Province points to SOP Triage and SOP Patient Observation that the management in triage is a maximum of 2 hours and patient observation is a maximum of 6 hours.
Based on the data currently available, in January 2022, the average performance is not under the SOP that has been set. The following is data obtained from the Emergency Room at RSUD dr. H. Abdul Moeloek Lampung Province. Based on Figure 1, we can conclude that 50% of patients management over 6 hours, meaning that only 50% of service performance was achieved according to the SOP. Organizational behavior is important in an organization, in this case, RSUD dr. H. Abdul Moeloek Lampung Province. The behavior that is meant here is individual in the delivery of services. Organizational Behavior becomes a place for individual people, organizational structure, and environment. Individual behavior has a central role, in RSUD dr. H. Abdul Moeleok has not carried out his role properly in utilizing available information technology as a support so that it has an impact on health services.
Besides, the Hospital Management Information System (SIMRS) as a Hospital information communication technology system that processes and integrates the entire process procedure of Hospital services is expected to be able to simplify a series of service activities systematically. Where is this management system has not run well, including the existing transaction menu has not been able to accommodate service needs, then the goal will not be achieved on time for existing health services.
The goal to be achieved in this study is to find out the influence of Organizational Behavior and Hospital Management Information System (SIMRS) on the Performance of Emergency Room Staff at the Regional General Hospital dr. H. Abdul Moeloek.

METHODS
Descriptive analytic with cross sectional design was used in this research. In conducting research to assess the influence of Organizational Behavior and Hospital Management Information Systems (SIMRS) on Employee Performance at the Emergency Room at the Regional General Hospital dr. H. Abdul Moeloek Lampung Province, the object of research was carried out at the Emergency Room at the Regional General Hospital dr. H. Abdul Moeloek Lampung Province. The research was carried out from February to March 2022. This study measured the characteristics of the population against indicators that presented all the variables that were studied through statements compiled in a questionnaire.
The population in this study were all employees at the Emergency Room at the Regional General Hospital RSUD dr. H. Abdul Moeloek Lampung Province, a total of 105 people. Based on the existing research population, the authors determined the research sample using the Slovin formula with an error tolerance limit of 5%, namely as follows: The sample in this study was selected using a simple random sampling technique so that the entire population has the same opportunity to become a member of the sample.

RESULTS AND DISCUSSION
Respondents were employees at the Emergency Room at RSUD dr. H. Abdul Moeloek Lampung Province which comes from medical and non-medical personnel with the following details:   The influence of SIMRS partially on the performance of the employees of the Emergency Room at the Lampung Provincial Hospital was carried out using the statistical t test (t test). The test results can be seen in the following table. The software design is implemented in two parts: acquiring front-end display data with the appropriate software and selecting software considering the low cost, minimal energy, and open (open-source). The program used in AQMP is Arduino for data acquisition using C/C++ language and Thinger-ESP32 for front-end display analysis.
The data acquisition software checks the sensor every five seconds, then saves the sensor data to an SD card and a MySQL database on the Thinger.io server. In addition, all data collected from sensors is entered into the MySQL database through prepared statements. This approach adds security to web applications by separating queries from data so that the data submitted cannot be used to change how queries are executed, thereby preventing injection attacks. Based on the result of calculation, the result shows that a equal to 0.152; b1 is 0.160 and b2 is 0.801. The form of the multiple linear regression equation is as follows: Ŷ = 0.152+0.160X1+0.801X2.
According to the regression equation, the influence of organizational behavior on employee performance is in the same direction. As the value of the regression coefficient in the regression equation shows a positive result of 0.160, this means that for every unit improvement in Organizational Behavior, there will be a 0.160 unit improvement in Performance. The influence of using SIMRS on performance shows linear results. This is shown in the regression coefficient or b2 value in the regression equation with a positive number of 0.801. This means that for every increase in SIMRS usage by 1 unit, it will be followed by an increase in performance of 0.801 units. The value of the coefficient a (intercept) is 0.152 which means that if there is no Organizational Behavior and the use of SIMRS (X1 and X2 = 0), it is estimated that the performance will remain at 0.152 units. the F statistical test (F test) is used to Test the influence of Organizational Behavior and The Use of SIMRS simultaneously on the author's performance. If the value of F count> F table then Ho is rejected and Ha is accepted. The results of hypothesis testing simultaneously can be seen in the following table: Based on the table above, it can be seen that the Organizational Behavior variable and the use of SIMRS variable have a simultaneous influence on performance. This can be seen based on the calculated F value of 629.378 which is bigger than the F table of 3.11. A significance value of 0.00 which is smaller than 0.05 indicates that simultaneously Organizational Behavior and the use of SIMRS have a significant influence on the performance of the employees of the Emergency Room at the Regional General Hospital of the Lampung Provincial Hospital. The influence of Organizational Behavior and Use of SIMRS variables describes that performance variables can be known from the value of the coefficient of determination (R Square) as follows: Based on the table above, it is known that the R Square value is 0.942, which means 94.2% of the changing variation regarding the performance dependent variable can be explained by the independent variables (Organizational Behavior and Use of SIMRS) while the remaining 5.8% is explained by other factors outside of this study.
The result of the regression direction coefficient between Organizational Behavior on performance is 0.904, this can be interpreted that if the Organizational Behavior score increases by one unit, then the employee performance score automatically also increases by 0.904. The better the organizational behavior of employees, the higher their performance. Organizational behavior is influenced by several components, this is in line with the definition (Robin: 2012) Organizational Behavior is defined as a combination of several components such as Behavior, motivation, and strength of leaders, structure and group processes, learning, interpersonal communication, perception, and development attitude, the process of change, conflict, work design, and work stress. The t value of the Organizational Behavior variable is 19.347 with a constant of 2.203 on the t table with a df of 79 with a significant level of 0.05, a value of 1.688 is obtained, then because t count > t table then Ha is accepted. The significance of the SIMRS usage variable in table B is 0.00 which means the probability is 0.00, because the probability is less than 0.05 then Ha is accepted, which means Organizational Behavior affects the performance of the employees of the Emergency Room at the Regional General Hospital RSUD dr. H. Abdul Moeloek Lampung Province. The percentage value of R Square is 0.826, meaning that 82.6% of the changing variation in performance variables can be explained by Organizational Behavior while the remaining 17.4% is explained by other variables outside of this research variable.
There are still employees who have not taken the effort to improve unsatisfactory job performance, as seen by the questioner where the respondent gave the lowest score for statement number 2 with a motivation indication. The phenomenon is that there are still employees who have not made an attempt to enhance their job outcomes. Of course, while carrying out his job, every individual is needed to work as hard as possible, with motivation being one of the indicators. Organizational Behavior is an aspect of behavior carried out by employees. As an important part of carrying out organizational behavior, employees at the Emergency Room at RSUD dr.H. Abdul Moeloek should continue to make improvements in carrying out his duties in accordance with the existing SOPs (Standard Operating Procedures), which can be started by increasing self-motivation. Self-evaluation can be done directly or indirectly in the process of providing health care. Directly, in the treatment of patients; indirectly, in the use of current information technology, such as SIMRS as a supporting tool and other supporting exams connected to the delivery of health-care services. Furthermore, it is expected that the leadership elements will be better able to carry out the supervisory function by focusing a persuasive approach and working together to create a pleasant work environment. Specifically, the re-implementation of the morning report, which is done on a regular basis.
Empirically, the results of this study are in line with the results of previous research, namely Sulaiman's research (2016), The Influence of Organizational Behavior on Employee Performance in the Treasury Section of the Finance Bureau of the Secretariat of West Java Province. The regression direction coefficient between the use of SIMRS on employee performance is 0.944 with a constant of 0.216. Thus, the regression equation is Y = 0.944 + 0.216X2, this can be explained that the use of SIMRS has a positive influence on the performance of the employees of the Emergency Room at the Regional General Hospital RSUD dr. H. Abdul Moeloek Lampung Province. The better the use of SIMRS is executed, the higher the employee performance will be. Conceptually this is in line with what is stated in the Minister of Health of the Republic of Indonesia No. 82 of 2013 regarding SIMRS, it is stated in article 2 that "SIMRS settings aim to improve efficiency, influenceiveness, professionalism, performance and access and hospital services". Article 2 paragraph 1 states that "every hospital is obliged to organize SIMRS". Article 4 paragraph 1 states that "every hospital must carry out the management and development of SIMRS". The Hospital Management Information System (SIMRS) is capable of processing highquality data from all work units in the hospital, so that information is more comprehensive and efficient in service. SIMRS that is implemented properly can support the management process and clinical services to be more influenceive and efficient, and can reduce service errors to patients.
The t-count value for using SIMRS is 34.342 with a constant of 1.857, in t-table with 79 db and a significant level of 0.05, 1.688 is obtained. Because t count > t table means Ha is accepted. The significance of the variable using SIMRS is 0.000 which means the probability is 0.000, because the probability is less than 0.05 which means Ha is accepted. It can be concluded that the use of SIMRS has an influence on the performance of the employees of the Emergency Room at the Regional General Hospital RSUD dr. H. Abdul Moeloek Lampung Province. The percentage value of the influence of using SIMRS on performance (R Square) is 0.937, meaning that 93.7% of the changing variation in performance variables can be explained by the variable using SIMRS while the remaining 6.3% is explained by other factors not examined in this study. This can be seen from the results of the quisoner where the lowest respondent answered in statement 4 with an indicator of accuracy and statement 10 with an indicator of increased efficiency. The phenomenon that occurs is that there are still inaccuracies and inefficiencies when using SIMRS in the Emergency Room at RSUD dr. H. Abdul Moeloek Lampung Province, namely in the transaction menu required in health services. The Hospital Management Information System (SIMRS) is expected to be able to provide accurate information and can help find information efficiently. So SIMRS needs to improve the quality of data input and supervision of all units so that data is guaranteed to be accurate and fast at the Emergency Room at the Regional General Hospital RSUD dr. H. Abdul Moeloek Lampung Province.
Empirically, the results of this study are in line with relevant previous research results. One of them is by Ni Made Ayu Maya Puspita Dodik Ariyanto influences of SIMRS use and Task suitability on Employee Performance at Wangaya Hospital, Denpasar City. Based on the calculation results obtained a of 0.152; b1 is 0.160 and b2 is 0.801. The form of the multiple linear regression equation is as follows: Ŷ = 0.152+0.160X1+0.801X2. From the linear regression it can be seen that the influence of Organizational Behavior on employee performance is unidirectional (positive), this is shown in the regression coefficient or the value of b1 in the regression equation which shows a positive number of 0.160 which means that every 1 unit increase in Organizational Behavior will be followed by performance increase of 0.160 units. The influence of using SIMRS on performance shows linear or positive results. This is shown in the regression coefficient or b2 value in the regression equation which shows a positive number of 0.801, which means that every increase in the use of SIMRS 1 unit will be followed by an increase in performance of 0.801 units. The value of the coefficient a (intercept) is 0.152 which means that if there is no Organizational Behavior and the use of SIMRS (X1 and X2 = 0), it is estimated that the performance will remain at 0.152 units. The calculated F value is 629.378 which is bigger than the F table of 3.11. The significance value is 0.00 which is less than 0.05 indicating that simultaneously organizational behavior and the use of SIMRS have a positive and significant influence on the performance of the employees of the Emergency Department at the Regional General Hospital RSUD dr. H. Abdul Moeloek Lampung Province. The percentage value of the influence of Organizational Behavior and Use of SIMRS on employee performance (R Square) is 0.942, which means 94.2% of the variation in variable changes regarding performance can be described by the independent variables (Organizational Behavior and Use of SIMRS) while the remaining 5.8% is explained by the factors, other factors that are not examined.
In this study, the combined variation of the two independent variables (Organizational Behavior and SIMRS Use) will affect increasing the dependent variable if the combined variation of the two independent variables (Organizational Behavior and SIMRS Use) is applied appropriately (performance). One of the components in achieving maximum performance is independence, which is obtained from the results of the lowest questionnaire in statement number 10 with the indicator of independence. Human resource independence will be improved if it is provided with a simple bureaucratic framework that allows for quick decision-making. Furthermore, human resources must improve their self-confidence as executors in carrying out their obligations or work. On the other side, there is something underlying in improving employee performance, namely the requirement for HR independence by continuous development to achieve RSUDAM's Vision and Mission as a community friend toward Healthy Lampung. The findings of this study could be used to improve employee performance at the Regional General Hospital RSUD dr. H. Abdul Moeloek Lampung Province.