Analysis of work environment and culture on service productivity with knowledge management mediation in Serang City Health Centers

The research aims to assess how much influence the work environment, work culture, and knowledge management have on service productivity at the Serang City Health Center. The difference with previous research by other researchers is the addition of other variables, namely the work environment and knowledge management. The quantitative research method used in this research is quantitative research. As many as 431 ASN at the Puskesmas in Serang City constitute the population in this study. The number of samples was determined based on the Slovin method; a total of 95 people participated. Smart PLS was used to analyze the questionnaire data. It can be seen that the work environment has a significant effect on knowledge management as well as work culture. Work culture has a large effect on service productivity, while the work environment has a large effect on knowledge management. There is a substantial relationship between knowledge management and service productivity. Knowledge management shows a significant relationship between the work environment and service productivity. The work environment has a significant impact on service productivity, as does knowledge management.


INTRODUCTION
The Community Health Center (Puskesmas), as a government organization, must be able to provide maximum service to the community.The Puskesmas is required to meet consumer needs through quality services, and the role of human resources is to support the Puskesmas in carrying out these services.By improving task-skill alignment and reducing redundant processes and unnecessary service delivery, health-care organizations have been able to free up costly specialist cases, and, in some cases, reorganization of care processes has also increased efficiency, allowing physical and staff resources to serve more.patients and reduce the cost of providing care (Brownlee et al., 2013).
Productivity is related to the work environment, which plays an important role in an organization.Most of the problems faced by employees are related to the work environment.Productivity levels can be increased through the development of a conducive work environment within the organization (Abdul & Awan, 2015).One of the things related to service productivity is service to Puskesmas visitors; this condition of the description of the service can be seen in the Community Satisfaction Index (IKM) figures, while at the IKM Puskesmas, it was identified that most of the IKM Puskesmas indicators in Serang City in general have achieved good qualifications or are satisfactory with the category of service quality B. However, there are still as many as six (6) indicators that are still of C quality, and if you look at the tendency that these indicators do not change or tend to decrease in value, this means that the performance of the Puskesmas in Serang City still has deficiencies in service matters.In this case, if there are still low-quality measurement results, this could indicate low productivity.Rahmawanti et al. (2014), creating a good work environment can affect employee performance.The physical work environment and non-physical work environment also affect employee motivation and morale because, if the work environment in the company is comfortable and pleasant, of course employees can improve their performance so that company goals can be achieved properly (Sari & Erlina, 2021).Apart from that, there are other related things.In addition, according to research (Suwaryo et al., 2015) on organizational culture, organizational commitment, and readiness to change, it was found that organizational culture influences organizational commitment and readiness to change.It can be seen that there is a cultural influence on all organizational goals.According to (Massoudi et al., 2017), there are significant environmental influences on work productivity.The influence of work culture on knowledge management can be explained by the results of this study.(Alias et al., 2018).The current research is different from previous studies, namely by adding the knowledge management variable to the service productivity variable.The goal of this study is to find out how the Serang City Health Center's service productivity is affected by the work environment, work culture, and knowledge management.

Thinking structure
Service productivity is very important because good service will increase the number of patient visits for treatment at health services.There are certain variables that affect service productivity, and a good work environment can increase service productivity.Besides that, the work culture factor of an organization can also affect service productivity because a good work culture can improve service to consumers so that they feel satisfied.The knowledge management factor is a variable that can have an impact on service productivity because this factor is a mediating factor, so productivity can be achieved through this factor.

Research hypotheses
The following hypotheses were formulated in the null form.
H1: It is suspected that the work environment influences knowledge management at the Serang City Health Center.H2: It is suspected that the work environment has an effect on service productivity at the Serang City Health Center.H3: It is suspected that work culture influences knowledge management at the Serang City Health Center.
H4: It is suspected that work culture influences service productivity at the Serang City Health Center.
H5: It is suspected that knowledge management has an effect on service productivity at the Serang City Health Center.H6: It is suspected that the work environment has an indirect effect on the productivity of patient services through knowledge management at the Serang City Health Center.H7: It is suspected that work culture has an indirect effect on service productivity through knowledge management at the Serang City Health Center.H8: It is suspected that the work environment, work culture, and knowledge management have an effect on productivity at the Serang City Health Center.

LITERATURE REVIEW
Productivity is synonymous with measuring efficiency and effectiveness in a service activity.Nangoy et al. ( 2020) said that productivity is a mental attitude that has the point of view that today will be better than yesterday (Afrizal et al., 2021).
Work productivity is the ratio between the results obtained (output) and the number of resources used as input.It is the relationship between the number of resources used and the number of results (Salam et al., 2022).
In research on the work environment, a positive and significant influence was found on both the physical work environment and the non-physical work environment on the performance of local government employees.Important factors in the physical work environment are cleanliness, air circulation, safety, and noise, while important factors in the non-physical work environment are the relationships between colleagues (Fithri et al., 2019).
Employee productivity (sometimes referred to as labor productivity) is an assessment of the efficiency of a worker or a group of workers.Productivity can be evaluated in terms of an employee's output over a given period of time.Usually, the productivity of a particular worker will be assessed relative to the average for employees doing similar work.Since a large part of the success of any organization depends on the productivity of its workforce, employee productivity is an important consideration for businesses (Massoudi et al., 2017).Satyvendra (2019) defines a work environment as one that can be as small and private as a head office or as public and large as a large organization or industry.Every day, centric concepts for things and various activities take place in the workplace, which are very important in shaping an organization and even the future career they have (Shammout, 2021).
The dimensions of the physical work environment are color, cleanliness, temperature, air circulation, lighting, security, and calm (Fithri et al., 2019).Meanwhile, Xue said that each individual who works in a team can unite their performance by sharing knowledge and recognizing the emotional expression of each member of the team through cultural factors (Jamshed & Majeed, 2019).
Factors that influence work culture According to Hofstede, there are four dimensions, namely as follows: 1) power distance (a measure of the relationship between workers and management); 2) individualism (a measure of how someone might make a difference between the interests of the organization and self-interest); 3) uncertainty avoidance (the level at which people are able to seek uncertainty and ambiguous situations); and 4) masculinity (the level at which success is defined as ambition, challenge, and humiliation rather than attention or promotion) (Shahzad et al., 2012).

METHODS
The population in this study was all civil servants in the city of Serang, which had 431 people.The Slovin formula is used to calculate the number of samples, and the sampling technique is proportional stratified random sampling, which is used when the population has heterogeneous and stratified members or elements proportionally, according to Sugiyono (2009).95people to determine sampling.Convergent Validity attempts to determine the validity of each relationship between the manifest and the construct or latent variable.As for the validity test with average variance extracted (AVE), based on the results shown in the table above, all variables have an AVE value greater than 0.5, which means that these variables are significant reliability test.
A reliability test is a test that measures the extent to which a measuring instrument performs measurements without bias (free of errors) and also ensures the consistency of the measuring instrument when used at a later time and across various items in the instrument (Sekaran and Bougie, 2016).
In this study, the composite reliability value for each construct has a value greater than 0.7, which means that all constructs are reliable.
Analysis of Variance (R2) or Determination Test the R Square value indicates the level of determination of exogenous, independent variables and endogenous, dependent variables.From table 1 above, it can be seen that the R-Square values for variables can be explained as follows: That knowledge management variables explained by work environment and work culture variables on knowledge management 54.4% while 45.6% are explained by other variables outside those studied.
That the service productivity variable is explained by the work environment variable, work culture on productivity 51.6% while 48.8% is explained by other variables outside those studied.

Path Coefficient
The analysis of bootstrapping produces a value contained in the coefficient for each relationship; the highest value can be seen from the relationship that occurs between work culture and knowledge management, namely a value of 0.565, while the lowest value can be seen from the work environment on service productivity, which is equal to 0.027.And for the other structural model relationships, it has a T-statistic value above 1.96, which illustrates the significance of the relationships in the research model.The following is the result of the path coefficient: Testing the research hypothesis was carried out with the help of SmartPLS (Partial Least Square) 3.2 software.These values can be seen from the bootstrapping results.The rules of thumb used in this study are t-statistics > 1.96 with a significance level of p-value 0.05 (5%) and a positive beta coefficient the bootstrapping results.The rules of thumb used in this study are t-statistics > 1.96 with a significance level of p-value 0.05 (5%) and a positive beta coefficient.The results are as follows: For success in achieving a goal, a good work culture and work environment are needed through knowledge management.These two things can increase the productivity of service to the community.A good work culture will build employees from within because culture is a set of values that are embedded in the minds of employees.Employees, while the work environment includes the physical aspects of the workplace environment that support service productivity.Knowledge management as a mediating factor is a system for organizing knowledge to achieve the goals of an organization, so this aims to achieve service productivity.

Hypothesis testing
Figure 1Thinking structure

Figure 3
Figure 3Test the significance of the bootstrapping model

Table 1
Analysis of Variance (R2) or Determination Test