THE INFLUENCE OF COMMUNICATION SKILL TOWARD EMPLOYEE PERFORMANCE IN RADIOLOGY INSTALLATION UNIT OF HOSPITAL

Staff performance is the result in quality and quantity that an employee can achieve in carrying out tasks related to the assigned responsibilities. Effective communication will help to create a healthy and open performance. This is very important in order to increase creativity and dedication of employees or staff at hospital. This research aims to analyze significant influence of leadership style and communication skills on staff performance by job satisfaction as intervening variable. Research method used here is quantitative research method method with causality research. The data source consists of primary data. The subjects of analysis were the employees in emergency radiology and diagnostic radiology. Data analysis was done byAMOS-path analysis. The results of the study showed that leadership style, communication skills and job satisfaction have a positive and significant effect on staff performance. Partially, there is a significant influence between communications on performance. The research findings show that leadership and communication styles may have a large direct influence on staff performance without influenced by job satisfaction. Leadership style has a negative influence on job satisfaction compared to staff performance. Communication skills have the greatest impact on improving staff performance compared to leadership styles and job satisfaction.


INTRODUCTION
Hospital is a business of service that provides social services in field of clinical medical aspect.Management of hospital as business unit has it own unique aspectapart from being a busines service, hospital also has social mission.Radiology services are services that inseparable from the health care system in hospitals.Therefore, they need to be directed and motivated in order to provide optimal capabilities for organization.Thus, it is consider as a job and challenge for the head of each unit in Hospital According to (Mathis, 2012), Individual's performance influenced by various factors, including: workforce ability, motivation, support received by individual variables, and their relationship with organization (communication). Schuller (1987) stated that "Employee

METHODOLOGY
This research was conducted at Hospital X Lebak Banten which is located in Lebak Banten. This research carried out from June 2020 to July 2020.Activities carried out by collecting theoretical data to support research, distributing questionnaires and drawing the conclusions from the conducted result.From the data questionnaire, the distribution of respondents was taken from 72 respondents who were studied at Hospital X, the number of female respondents was more than male respondents with the percentage of 38 female (52.8%) and 34 male (47, 2%).Most of respondents aged 26-35 years were 34 people (47.2%). Most of the respondents had D3 education as 34 people (47.2%). For central diagnostic radiology unitand emergency radiology unit, there were 24 nurses (33.3%), 13 radiographers (18.1%), 2 sonographer (2.8%), 1 fismed (1.4%), 3 Dr.Sp.Rad (4.2%), a radiophotography officer (1.4%) and other medical support (38.8%).
This research is a quantitative analytic study with a causality research design. Causal research design is a research design that useful for analyzing the influence of a variable on another.The influence characteristic that might happen among variables is symmetric, asymmetric and reciprocal. Data collection was done by distributing questionnaires.The data collection was processed by descriptive and quantitative analysis tools.The analysis technique used to analyze the SPSS data is path analysis. Soekardi, A., Indrawati, R. and Erni, N. (2020), "The influence of communication skill toward employee performance in radiology installation unit of hospital", Management and entrepreneurship: trends of development, Volume 4, Issue 14, pp. 31-42. Available at: https://doi.org/10.26661/2522-1566/2020 Data collection techniques in this study using saturated sample data (Total Sampling). The questionnaire is the research instrument based on different set of questions for the purpose of gathering information from the respondents across various fields (Farooq, 2018). The validity test is a measuring tool that shows the level of accuracy of instrument. Validity test uses Pearson Product Moment Correlation, a variable consideras valid if the value of r count> r table.Reliability test is a measuring tool to determine which instruments can be consistently trusted.Reliability test using measurement techniques of Chronbach Alpha, the data result can be said as reliable if Chronbach Aplha > 0,6. Thethree box method analysis aims to determine a descriptive of respondents.The scoring technique used is a range of maximum score of 5 and minimum score of 1.

Validity Test and Reliability Test
Significance test was carried out by the criteria of r table at significance level of 0.05 with 2sided test.If the value is positive and r count  r table then the item conside as valid, if r count <r table, then the item consider as invalid. While reliability test used coefficient alphaCronbach's Alpha is a reliability coefficient that shows how well the items in a set are positively correlated with each other.(Cronbach's Alpha) was calculated in terms of the average intercorrelation between items measured concepts.The closer Cronbach's Alpha to a value of 1, the higher internal consistency reliability.Questionnaire items that have an alpha value above 0.6 considered as reliable (Hair, J. F., Black, W. C. and Anderson, 2010). A variable construct can be said as good if it has Cronbach's Alpha more than 0.60. Here are the results of reliability test for research variables: The reliability test results show that all variables of Communication Ability, Job Satisfaction and Employees Performance, have Cronbach's Alpha coefficient above 0.6. Thus, the questionnaire in this study declared as reliable.

Normality Test
Normality Test has an aim to examine whether in path analysis model, dependent variable, independent variable or both has normal distribution or not.A research equation / model consist of several variables with tens or hundreds data on each variable.Before the data analysis stage is carried out, it must be proven that the data is normally distributed; therefore it is feasible to be analyzed for the next stage.Multivariate normality can be seen from cr value of kurtosis on the last row higher than ± 2.58. In table 2 below, it can be seen that cr value in last row kurtosis is 2.070 (normal).

Source : the result of data analysis AMOS-path analysis
Based on the results of processing data shown in the Table above. It can be seen that p-value is 0.255, which indicates that p-value (0.255)> 0.05 (α), Thus, that the data used in this study are normally distributed.

Multicollinearity Test
This test was done by observed determinant of the covariance matrix. if the value were small, thus it indicates a multicollinearity. In this research, the determinant value of covariance matrix was 0.001 (positive results and higher than 0.000) it means that there was no multicollinearity.

Simultanous Test
Measurement model test is testing the relation between indicators with the latent variable. It combined the structural test model and measurement that allow the researcher to test the measurement erroras inseparable part AMOS-path analysisafter the analysis factor along with hypothesis test.In measurement model test, Chi-square result is 2,760 (it has small value, therefore simultaneous test is accepted), 1 degrees of freedom and a probability level of 0.097> 0.05, indicates that the first hypothesis (H1) is accepted.

Determination Coefficient Test (R 2 )
The analysis of determination influence inside AMOS-path analysis used to know the contribution of exogenous variable toward endogenous variables. Determination coefficients can be seen in the Squared Multiple Correlations table. Source: AMOS processed data Soekardi, A., Indrawati, R. and Erni, N. (2020), "The influence of communication skill toward employee performance in radiology installation unit of hospital", Management and entrepreneurship: trends of development, Volume 4, Issue 14, pp. 31-42. Available at: https://doi.org/10.26661/2522-1566/2020-4/14-03 35 Based on table 3, the estimated value of job satisfaction variable is 22.8% and the estimated performance variable is 30.3%. In this study, job satisfaction variable influenced by leadership style and communication. Performance variable is influenced by leadership style, communication and job satisfaction. From the results of determination analysis, it can be concluded that the influence of leadership style, communication and job satisfaction on performance is 30.3%, while the remaining 59.7% is influenced by other factors outside the research such as work motivation, leadership style, work environment and other.

Partial Test
Based on the table below, it shows that the influence of leadership style on work satisfaction has CR value of -0.766 (p = 0.443> 0.05), while the influence of communication on job satisfaction has CR of 4,120 (p=0,000<0,05). For the effect of job satisfaction on employee performance has CR of 2,615 (p=0,009<0,05), the influence of leadership style toward work performance has CR of -3,519 (p=0,000<0,05), and the influence of communication topward job performance has CR value of 3,103 (p=0,002<0,05).

The influence of leadership style and communication skills toward job satisfaction by career development as intervening variable
Based on the research result, it obtain Chi-square of 2,760, 1 degrees of freedom and probability level of 0,097>0,05, thus the simultant test is accepted. The results of analysis on determination coefficient (R2) showed that leadership style; communication and job satisfaction toward work performance was 30.3%, while the remaining 59.7% was influenced by other factors outside the research such as work motivation, leadership style, work environment and others.
H1, there is significant influence ofleadership style and communication skill toward staff performance through job satisfaction as Intervening variable, accepted.

The influence of leadership style toward staff work performance
Through statistical calculations by Amos V23, it is known that the estimated influence of leadership style on staff performance is -0.274, the CR value is -3.519 and p-value is 0.000 <0.05.Therefore, HO is rejected and H2 is accepted, it means that there is a negative and significant influence of leadership style toward staff performance.Based on the estimated value of leadership style, it has influence of 27.4% on staff performance, the remaining 72.6% is influenced by other variables, it can be concluded that there is a significant influence of leadership style towardwork performance.
H2, there is an effect of leadership style toward staf performance in Radiology Installation of Hospital X

The influence of Communication toward Staf Performance
Based on the results of statistical testing on estimated value, it is known that the effect of communication on staff performance obtain 0.391, CR value is 3.103 and p-value is 0.002 <0.05, therefore H0 is rejected and H3 is accepted. It means that communication has positive and significant influence toward staf performance.Based on the estimated value, communication has an effect of 39.1% toward staff performance, the rest 60,9% influenced by other variable,it can be concluded that there are significant influence on communication toward work performance.
H3, there is an effect of communication skill toward staff performance in Radiology Installation of Hospital X, this hypothesis is approved.

The Influence of Leadership style toward Job Satisfaction
Based on the results of statistical testing on estimated value, it is known that the influence of leadership style on job satisfaction is -0.079, CR value is -0.766 and p-value is 0.443> 0.05, it means that there is no positive and significant influence on leadership style toward job satisfaction, therefore H0 is accepted and H4 is rejected. From the estimated value, the influence of leadership style toward job satisfaction is 7.9% and the remaining 92.1% is influenced by other variables.Based on the result above, it can be concluded that there is no significant influence on leadership style toward job satisfaction.
H4, There is no influence of leadership style toward job satisfaction in Installation Radiology of Hospital X, Hypothesis rejected.

The Influence of Communication toward Job Satisfaction
Based on the results of statistical testing, it is known that the estimated value on the influence of communication toward job satisfaction is 0.618, CR value is 4.120 and p-value is 0.000 <0.05, this value indicated the results that meet the requirements, <0.05 for P, it can be concluded that Ho is rejected and H5 is accepted.From the estimated value, the influence of communication toward job satisfaction obtains 61.8%, and the remaining 38.2% is influenced by other variables.Based on those results, it can be concluded that there is significant influence on communication towards job satisfaction. Soekardi, A., Indrawati, R. and Erni, N. (2020), "The influence of communication skill toward employee performance in radiology installation unit of hospital", Management and entrepreneurship: trends of development, H5, There is an influence of Communication toward Job Satisfaction of Installation Radiology Hospital X, Hypothesis approved.

The Influence of Job Satisfaction toward Staf Performance
Through the calculation of statistical testing by Amos-path analysis V23, it is known that the estimated value onthe effect of job satisfaction toward staff performance obtain 0.235, CR value is 2.615 and p-value is 0.009 <0.05. This value shows the results that meet the requirements, are less than 0.05 for P, thus it can be concluded that H0 is rejected and H6 is accepted. Based on the estimated value, the effect of job satisfaction toward staff performance is 23.5%, the remaining 66.5% is influenced by other variables.Based on the result above, it can be concluded that there are significant influence of job satisfaction toward work performance.
H6, There is an influence of Job Satisfaction toward Staf Performance in Installation Radiology of Hospital X. Hypothesis approved.

Intervening Test
The intervening test is carried out by comparing the direct effect and indirect effect of independent variables, such as leadership style and communication on dependent variable, such as staff performance.The direct effect occurs when a variable affect other variables without any third variable intervening the relationship between those two variables. Indirect Influence occurs if there is other third variable occur as intervening variable.
The intervening test was calculated by looking at the value of standardized direct effects and standardized indirect effects on estimated parameters whichindirect effect is higher than direct effect (PTL> PL). The influence of leadership style on staf work performance at Radiology Installation of Hospital X Based on statistics of AMOS V23, it is known that the estimated influence of leadership style on staff performance is -0.274, with CR value of -3.519 and p-value 0.000 <0.05, thus HO is rejected and H2 is accepted, it means that there is a negative and significant influence of leadership style toward staff performance. Based on the estimated value, leadership style has influence of 27.4% on staff performance, the remaining 72.6% is influenced by other variables, it can be concluded that there is a significant influence of leadership style toward staff performance.
It can be concluded that leadership style is an effective strategy to influence a group on achieving their goals.Effective leaders not only use their power to encourage employees but also provide motivation, inspiration and loyalty for employees thus, the employee able to devote all the focus of their abilities to achieve optimal performance.

The influence of communication skill on the staff performance at Radiology Installation Hospital X
Based on the results of AMOS V23 statistical test on estimated value, it is known that the effect of communication on staff performance obtain 0.391 with CR value of 3.103 and p-value is 0.002 <0.05, therefore H0 is rejected and H3 is accepted. It means that communication has positive and significant influence on staff performance. Based on the estimated value, communication has 39.1% effect on staff performance, the rest 60.9% influenced by other variables, therefore it can be concluded that there is significant influence of communication skill toward staf performance.
Based on descriptive analysis by three box method, the highest index value is an indicator of information regarding organizational procedures and practices. Employees feel that social relationship in hospital such as communication among employees consider as good, however in terms of facilities, employees feel that hospital did not provide a good facilities.
It can be concluded that communication in service organization determined by internal communication and simultanousely influence toward work improvement.

The Influence of Leadership style toward Job Satisfaction in Radiology Installation of Hospital X
Based on the results of AMOS V23 statistical test on estimated value, it is known that the influence of leadership style on job satisfaction is -0.079, CR value is -0.766 and p-value is 0.443> 0.05, it means that there is no positive and significant influence of leadership style toward job satisfaction, then H0 accepted and H4 rejected. From the estimated value, the influence of leadership style on job satisfaction is 7.9% and the rest 92.1% is influenced by other variables. Based on these results, it can be concluded that there is no significant influence of leadership style on job satisfaction.
Based on descriptive analysis, the lowest index value was found in the indicators of developing the current system.About 20% of employees disagreed with this question.it means that employees feel that leadership style of the room's head and the installation's head comes from different work experience and different educational backgrounds. Therefore, their leadership style also different Based on the research results which supported by previous research, it can be concluded that the results of leadership style do not have a significant effect on job satisfaction.It is because the variable of leadership style and job satisfaction variable consist of several kind of dimensions. Therefore, in certain research objects, the conditions of leadership style variable on the job satisfaction variable cannot be completely fullfilled.

The Influence of Communication skill toward Job Satisfaction of Radiology Installation at Hospital X
Based on the results of AMOS V23 statistical test, it is known that the estimated value of communication influence toward job satisfaction is 0.618, with the CR value of 4.120 and p-value of 0.000 <0.05, this value indicates that the results meet the requirements, <0.05 for P, therefore, Ho is rejected and H5 is accepted.The estimated value of communication influence toward job satisfaction is 61.8%, and the rest 38.2% is influenced by other variables.Based on these results, it can be concluded that there is significant influence ofcommunications toward job satisfaction.
Researchers conclude that if the leaders and it subordinates did not have effective communication and currently in constant conflict, work motivation will be weak and the productivity will be declined. Effective communication will develop employee satisfaction and productivity; improve the achievement of work and achieve the goals.

The Influence of Job Satisfaction toward Staff Performance in Radiology Installation of Hospital X
Based on the calculation of statistical testing AMOS-Path analysis V23, it is known that the estimated value on the effect of job satisfaction toward staff performance is 0.235, with CR value of 2.615 and p-value is 0.009 <0.05, this value indicates that the result qualifies less than 0.05 for P, therefore it can be concluded that H0 is rejected and H6 is accepted.From the estimated value, the effect of job satisfaction toward staff performance is 23.5%, and the rest 66.5% is influenced by other variables. Based on these results, there can be a significant influence between satisfaction and performance.
Based on descriptive analysis by three box method, the highest index value is an indicator of obtained work or expected work (income, promotion), there are 56.4% of employees agree with job promotion system in hospital. Career development system in hospital has been implemented; however the level of career development promotion system made by hospital management is not related to employee expectations.
Researchers obtain the conclusion that job satisfaction has significant positive effect on staff performance.This indicates that the higher employee's job satisfaction, employees will show their best performance.If hospital or company always implements the career system and compensate it properly, a good relation among co-workers, the motivating attitude of leader, and condusive physical work environment will help the employee become more comfortable on working.And it causes maximum performance of employeeand can be seen by how the employee begin to work their best and always tries to provide the best service to customers.

CONCLUSION
A capable communicative leadership style will create job satisfaction within each subordinate, and it will help to improve staff performance. This is because the leadership style variable and job satisfaction variable consist of many dimensions therefore in certain research objects, the conditions of leadership style variable influence the job satisfaction variable cannot be fulfilled completely.
Another finding is that effective communication is the most influential factor in staff performance.From this effective communication a good relationship was created between leader and staff. In this communication there is satisfaction and motivation, therefore staff performance will increase.It is showed a positive direction of relationship between communication and performance and it can be interpreted that, the more effective communication, the more employee's performance increase, it is related to Abraham Maslow's hierarchy theory of needs.
Leadership style, communication skills and job satisfaction simultaneously have positive and significant effect on staff performance. Communication skills have positive and significant effect on staff performance. Leadership style and communication skills partially influence staff performance.

SUGGESTION
Hospital Management system should have an effort to establish a remuneration system for workloads, years of service, education, experience and work performance of employees. By providing good compensation, it can be directly improve employee welfare and make employees want to have a commitment for hospital. Provide a reward system in form of training and skills development for those who has a good performance, therefore employees will feel motivated to obtain more achievements at work. Provide a punishment system for employees who have bad behavior, thus it encourage them to improve their performance and provide facilities to support more effective and efficient work, such as repaire and refine the hospital information system (SIMRS) into an integrated system.