Performance Transformation in the Health Sector: The Effects of Flexible Working Arrangements and Organizational Support on Employee Performance at the Center for Health System Resilience Policy Indah SulistyowatiA.
Holy Arif WibowoA.
Intan Sari OktoberiaA.
ZaharuddinA.
Irawan R.
BudiantoAA a Center for Health System Resilience Policy.
Ministry of Health.
Republic of Indonesia a Faculty of Management and Business.
Universitas Mitra Bangsa.
Indonesia Correspondence: indahsulistyowati26@gmail.
holyarif@gmail.
sarioktoberia@gmail.
irawanrenataduta@gmail.
ABSTRACT
The COVID-19 pandemic accelerated the adoption of flexible working arrangements (FWA) in public institutions, yet evidence on whether such arrangements strengthen bureaucratic performance remains contextdependent.
This study examines the effects of FWA and organizational support on employee performance at the Center for Health System Resilience Policy.
Ministry of Health of the Republic of Indonesia.
Using a quantitative cross-sectional design, data were collected from the full population of 56 employees through a structured questionnaire.
The instrument measured FWA through time, timing, and place flexibility.
organizational support through emotional, instrumental, informational, evaluative, and appreciative support.
and employee performance through work quality, quantity, responsibility, cooperation, and initiative.
The measurement model met validity and reliability criteria, and the regression diagnostics indicated normally distributed residuals, no heteroscedasticity, and no multicollinearity.
The results show that FWA significantly predicts employee performance (B = 0.
583, t = 2.
332, p = 0.
, and organizational support also significantly predicts employee performance (B = 0.
399, t = 390, p = 0.
Simultaneously, both predictors explain 24.
8% of the variance in employee performance (R = 0.
adjusted RA = 0.
F =
089, p < 0.
These findings indicate that flexible work policies are more likely to improve performance when embedded in a supportive organizational system that provides clear guidance, adequate resources, and leadership support.
The study contributes empirical evidence from an Indonesian public health policy institution and offers practical implications for designing adaptive, accountable, and performance-oriented work arrangements in the public sector.
DOI.
https://doi.
org/10.
56442/ijble.
Keywords: flexible Ministry of Health
INTRODUCTION
The COVID-19 pandemic reshaped work systems in both private and public In Indonesia, as in many other jurisdictions, mobility restrictions required public institutions to maintain service continuity while reducing face-to-face This institutional pressure accelerated the use of flexible working arrangements (FWA), including remote work, flexible scheduling, and technologymediated coordination.
Prior research on telework and work-from-home arrangements indicates that flexibility can improve autonomy, satisfaction, and performance under appropriate task, supervisory, and technological conditions (Allen et al.
, 2015.
Bloom et al.
, 2015.
Gajendran & Harrison, 2.
Flexible working arrangements are commonly understood as employment practices that give employees greater discretion over when, where, or how work is In knowledge-intensive and administrative work, such arrangements may help employees manage work-life demands, reduce commuting burdens, and sustain concentration.
However, the performance implications of FWA are not automatic.
Systematic reviews emphasize that the business case for flexible work depends on implementation quality, monitoring mechanisms, managerial support, and the characteristics of the tasks being performed .
e Menezes & Kelliher, 2011.
Kossek & Lautsch, 2.
Organizational support is therefore central to understanding whether FWA produces beneficial outcomes.
Perceived organizational support theory proposes that employees form general beliefs about the extent to which the organization values their contribution and cares about their well-being (Eisenberger et al.
, 1986.
Rhoades & Eisenberger, 2.
In flexible work contexts, support may take the form of leadership trust, clear work procedures, access to digital infrastructure, feedback, recognition, and equitable opportunities for professional development.
When these forms of support are absent, flexibility can create ambiguity, coordination problems, and unequal access to resources.
The public sector context makes this issue particularly important.
Employee performance in government institutions is linked not only to internal efficiency but also to public trust, service reliability, and policy responsiveness.
Within the Ministry of Health, flexible work must be evaluated in relation to bureaucratic reform objectives, accountability, and the continuity of health policy services.
Recent studies have examined FWA, perceived organizational support, work engagement, and performance across Indonesian and international contexts (Alyahyaee & Abd Razak.
Desa & Asaari, 2025.
Rahmawati & Pusparini, 2023.
Sari & Rofiqoh, 2026.
Yamin & Pusparini, 2.
Nevertheless, empirical evidence remains limited for public health policy institutions in Indonesia.
This study addresses that gap by examining whether FWA and organizational support predict employee performance at the Center for Health System Resilience Policy.
Specifically, the study aims to: .
analyze the effect of FWA on employee .
evaluate the effect of organizational support on employee and .
assess the simultaneous effect of FWA and organizational support on employee performance.
By preserving the institutional context and empirical data of the original study, this article provides evidence-based input for improving flexible work policies in government organizations.
Literature Review and Hypothesis Development Flexible Working Arrangements and Employee Performance FWA refers to work practices that increase employee control over work time, work location, and work processes.
Theoretical and empirical work on telecommuting suggests that flexibility can support performance by increasing autonomy and reducing interruptions, but it may also weaken social interaction and coordination if not implemented carefully (Allen et al.
, 2015.
Gajendran & Harrison, 2.
Experimental evidence from a large work-from-home trial also shows that home-based work can increase performance when tasks are measurable and the work environment supports concentration (Bloom et al.
, 2.
In the present study.
FWA is measured through time flexibility, timing flexibility, and place flexibility.
H1: Flexible Working Arrangements have a positive and significant effect on employee performance.
Organizational Support and Employee Performance Organizational support reflects employees' perceptions that the organization values their contribution and cares about their well-being (Eisenberger et al.
, 1986.
Rhoades & Eisenberger, 2.
Under social exchange theory, employees who perceive strong organizational support are more likely to reciprocate through commitment, responsibility, and higher performance.
In the context of FWA, organizational support is especially relevant because employees require infrastructure, information, feedback, and supervisor trust to perform effectively outside conventional office-based arrangements.
This study operationalizes organizational support through emotional support, instrumental support, informational support, and evaluative and appreciative support.
H2: Organizational support has a positive and significant effect on employee performance.
Simultaneous Role of FWA and Organizational Support Flexible work policies and organizational support are conceptually Flexibility provides autonomy, while support provides the resources and institutional clarity needed to use that autonomy productively.
Prior studies indicate that FWA and perceived organizational or supervisory support may jointly improve engagement and performance outcomes (Rahmawati & Pusparini, 2023.
Yamin & Pusparini, 2.
Therefore, the simultaneous effect of both variables must be tested to determine whether flexible work policies operate as part of a broader organizational system.
H3: Flexible Working Arrangements and organizational support simultaneously have a positive and significant effect on employee performance.
METHOD
Research Design.
Site, and Sample This study employed a quantitative, descriptive, and correlational research The research was conducted at the Center for Health System Resilience Policy under the Health Policy Development Agency.
Ministry of Health of the Republic of Indonesia.
Jakarta.
The research period covered August 2025 to February 2026.
The population consisted of 56 employees at the Center for Health System Resilience Policy.
Because the population was fewer than 100 individuals, a non-probability saturated sampling approach, also referred to as a census approach, was applied.
Accordingly, all 56 employees were included as respondents.
Variables and Measurement The study examined three variables.
Flexible Working Arrangement (X.
was measured using indicators of time flexibility, timing flexibility, and place flexibility.
Organizational Support (X.
was measured using indicators of emotional support, instrumental support, informational support, and evaluative and appreciative support.
Employee Performance (Y) was measured using indicators of quality of work, quantity of work, responsibility, cooperation, and initiative.
Data were collected through a structured questionnaire using a Likert-type response scale.
Data Analysis The data were analyzed using IBM SPSS.
The analysis consisted of descriptive statistics, item validity testing using Pearson product-moment correlation, reliability testing using Cronbach's alpha, and classical assumption tests including normality, heteroscedasticity, and multicollinearity.
Multiple linear regression was then used to test partial effects through t-tests and simultaneous effects through the F-test.
The interpretation of correlation strength followed conventional behavioral science effectsize guidance (Cohen, 1.
, while reliability and normality procedures were guided by established methodological references (Cronbach, 1951.
Ghozali, 2018.
Nunnally & Bernstein, 1994.
Razali & Wah, 2011.
Sugiyono, 2.
RESULTS AND DISCUSSION
Respondent Profile The demographic profile of the 56 respondents is presented in Table 1.
The sample was dominated by female respondents .
9%).
The largest age group was 41-50 years .
9%), followed by 31-40 years .
3%).
Most respondents held a master's degree .
1%) or bachelor's degree .
3%), indicating that the organization has a highly educated workforce.
Table 1.
Frequency Distribution of Respondents Variable Gender Category Male Female 20-30 years 31-40 years 41-50 years 51-60 years Doctoral (S.
Master's (S.
Bachelor's (S.
Diploma IV Diploma i Age Education Frequency .
Percentage (%) Source: Primary data, 2026.
Descriptive Statistics of Research Variables Descriptive statistics were used to identify the minimum score, maximum score, total mean, item mean, and standard deviation for each variable.
Following the scale categorization used in the original analysis, mean scores were classified as follows:
80 = very low, 1.
60 = low, 2.
40 = moderate, 3.
20 = good, and 00 = very good.
Table 2.
Descriptive Statistics Summary Total Mean Good Good Variable FWA (X.
Organizational Support (X.
Employee Performance (Y) Min Max Item Mean Std.
Dev.
Category Good Source: Processed SPSS output, 2026.
Table 2 shows that all variables fall within the good category.
FWA recorded an item mean of 3.
51, employee performance recorded an item mean of 3.
47, and organizational support recorded an item mean of 3.
The relatively higher standard deviation for organizational support indicates greater variation in employees' perceptions of the support they receive, compared with FWA perceptions.
Validity Test Item validity was evaluated using Pearson product-moment correlation.
With 56 respondents and a 5% significance level, the r-table value was 0.
Items were considered valid when their r-calculated values exceeded 0.
Table 3.
Summary of Validity Test Results Variable FWA (X.
Organizational Support (X.
Employee Performance (Y) Items X1.
1-X1.
r-Calculated Range r-Table X2.
1-X2.
Y1.
1-Y1.
Source: Processed SPSS output, 2026.
All questionnaire items met the validity requirement because every r-calculated value exceeded the r-table value.
The performance variable showed the strongest item correlations, ranging from 0.
682 to 0.
855, indicating strong alignment between its indicators and the performance construct.
Reliability Test Reliability was assessed using Cronbach's alpha.
A threshold of 0.
60 was used in the original study to determine acceptable internal consistency.
The results are presented in Table 4.
Table 4.
Reliability Test Summary Variable FWA (X.
Organizational Support (X.
Employee Performance (Y) Cronbach's Alpha Minimum Threshold Status Reliable Reliable Reliable Source: Processed SPSS output, 2026.
The Cronbach's alpha values for FWA and organizational support were both 693, exceeding the minimum threshold.
Employee performance obtained a substantially higher alpha value of 0.
943, indicating very strong internal consistency among the performance indicators.
Classical Assumption Tests Normality Test The One-Sample Kolmogorov-Smirnov test was used to evaluate the normality of the unstandardized residuals.
As shown in Table 5, the significance value was 061, which is higher than the 0.
05 threshold.
Therefore, the residuals are normally This conclusion is consistent with the Normal P-P plot and histogram shown in Figures 1 and 2.
Table 5.
Kolmogorov-Smirnov Normality Test Summary Variable Unstandardized Residual Sig.
Threshold Result > 0.
Normal Source: Processed SPSS output, 2026.
Figure 1.
Normal P-P plot of standardized residuals for the employee performance regression model.
Source: Processed SPSS output, 2026.
Figure 2.
Histogram of standardized residuals for the employee performance regression model.
Source:
Processed SPSS output, 2026.
Heteroscedasticity Test Heteroscedasticity was examined using significance values for the independent variables and visual inspection of the scatterplot.
Table 6 indicates that the significance values for FWA .
and organizational support .
were both greater than 0.
Therefore, the model does not show evidence of heteroscedasticity.
The scatterplot in Figure 3 also shows residuals distributed around the zero line without a systematic pattern.
Table 6.
Heteroscedasticity Test Summary Variable FWA (X.
Organizational Support (X.
Significance (Sig.
Threshold > 0.
Result No heteroscedasticity > 0.
No heteroscedasticity Source: Processed SPSS output, 2026.
Figure 3.
Scatterplot of standardized predicted values and studentized residuals.
Source: Processed SPSS output, 2026.
Multicollinearity Test Multicollinearity was assessed using tolerance and variance inflation factor (VIF) values.
The results in Table 7 show that both independent variables had tolerance values of 0.
971 and VIF values of 1.
Since tolerance values exceeded 10 and VIF values were below 10, the regression model was free from Table 7.
Multicollinearity Test Summary Variable FWA (X.
Organizational Support (X.
Tolerance VIF Result No multicollinearity No multicollinearity Source: Processed SPSS output, 2026.
Multiple Correlation and Determination Analysis The multiple correlation coefficient (R = 0.
indicates a positive relationship of moderate-to-strong magnitude between FWA, organizational support, and employee performance.
The adjusted RA value of 0.
248 shows that FWA and organizational support jointly explain 24.
8% of the variance in employee performance.
The remaining 75.
2% is associated with factors outside the model, such as motivation, leadership, work environment, organizational culture, coordination mechanisms, and other individual or institutional variables.
Table 8.
Model Summary Model R Square Source: Processed SPSS output, 2026.
Adjusted R Square Std.
Error of the Estimate Multiple Linear Regression and Hypothesis Testing Multiple linear regression was used to examine the partial and simultaneous effects of FWA and organizational support on employee performance.
The results are presented in Table 9.
Table 9.
Multiple Regression Results Variable (Constan.
FWA (X.
Organizational Support (X.
Coefficient (B) t-Statistic Sig.
Result Significant Significant F-statistic Sig.
Simultaneously Source: Processed SPSS output, 2026.
The resulting regression equation is: Employee Performance = 7.
583(FWA) 0.
399(Organizational Suppor.
H1 is supported because FWA significantly predicts employee performance .
= 2.
p = 0.
This result indicates that higher levels of perceived work flexibility are associated with better employee performance.
H2 is also supported because organizational support significantly predicts employee performance .
= 3.
Compared with FWA, organizational support shows a stronger t-statistic, indicating that the support system surrounding employees is a salient performance H3 is supported because the F-test is significant (F = 10.
p < 0.
confirming that FWA and organizational support simultaneously predict employee Discussion Flexible Working Arrangements and Performance The significant positive coefficient of FWA supports the argument that flexibility can enhance employee performance when employees are able to align work demands with their most productive conditions.
This finding is consistent with prior telework and FWA research showing that flexibility can improve performance through autonomy, reduced work-life conflict, and improved concentration (Allen et al.
, 2015.
Bloom et al.
Gajendran & Harrison, 2.
In the Center for Health System Resilience Policy.
FWA may help employees manage analytical, administrative, and coordination tasks more effectively, particularly when work can be conducted through digital systems.
Nevertheless, the coefficient should be interpreted carefully.
FWA alone explains only part of performance variation, and its success depends on managerial and institutional conditions.
This is consistent with the broader literature indicating that flexible work may produce mixed results when implementation mechanisms, task suitability, and organizational expectations are unclear .
e Menezes & Kelliher, 2011.
Kossek & Lautsch, 2.
Organizational Support as a Performance Enabler Organizational support also has a positive and significant effect on This result is aligned with perceived organizational support theory, which argues that employees reciprocate perceived care and appreciation from the organization through greater commitment and performance (Eisenberger et al.
, 1986.
Rhoades & Eisenberger, 2.
In practical terms, employees are more likely to perform well when they receive adequate resources, clear information, constructive feedback, appreciation, and leadership support.
The finding that organizational support has a stronger t-statistic than FWA suggests that flexibility needs an enabling institutional environment.
In public organizations, where accountability and service continuity are essential, employees require not only freedom to choose work arrangements but also explicit performance standards, digital infrastructure, and supervisor trust.
This interpretation is consistent with empirical studies showing that perceived organizational and supervisory support strengthens the performance impact of flexible work arrangements (Rahmawati & Pusparini, 2023.
Yamin & Pusparini, 2.
Strategic Synergy between FWA and Organizational Support The simultaneous significance of FWA and organizational support demonstrates that flexible work should be treated as an integrated organizational policy rather than an isolated administrative privilege.
FWA provides autonomy, while organizational support provides the resources, norms, and feedback mechanisms needed to convert autonomy into measurable performance.
The adjusted RA value of 248 is meaningful in behavioral and public-sector research, but it also indicates that employee performance is influenced by additional factors beyond the model.
Therefore, future performance improvement initiatives should consider motivation, leadership quality, organizational culture, coordination effectiveness, performance management systems, and technological readiness.
For the Center for Health System Resilience Policy, the findings imply that flexible work policies can contribute to bureaucratic reform if accompanied by adequate institutional support.
This includes clear performance indicators, equitable access to technology, structured communication routines, supervisor capacity to manage hybrid teams, and mechanisms to prevent coordination gaps.
In this sense, flexible work is not merely a post-pandemic work pattern but a strategic management instrument for building an adaptive and resilient public organization.
CONCLUSION
This study examined the effects of FWA and organizational support on employee performance at the Center for Health System Resilience Policy.
Ministry of Health of the Republic of Indonesia.
The findings lead to three conclusions.
FWA significantly predicts employee performance.
Work flexibility enables employees to manage time, workload, and work location more effectively, which supports overall work quality and effectiveness.
Organizational support significantly predicts employee performance.
Support provided through policies, leadership, facilities, information, feedback, and appreciation creates a conducive work environment and encourages employees to maximize their contribution.
FWA and organizational support simultaneously predict employee performance.
Performance improvement is therefore best understood as the result of a strategic combination of flexible work policy and institutional support.
The study contributes empirical evidence from an Indonesian public health policy institution and highlights the importance of embedding flexible work policies within a structured organizational support system.
For managerial practice, the organization should strengthen digital infrastructure, clarify performance expectations, improve supervisor support, and ensure that flexibility is implemented fairly across employee groups.
Limitations and Future Research This study has several limitations.
First, the sample was limited to one public health policy institution with 56 employees.
therefore, generalization to other publicsector organizations should be made cautiously.
Second, the study used self-reported questionnaire data, which may be influenced by common-method bias.
Third, the cross-sectional design limits causal inference.
Future studies should use multi- institutional samples, longitudinal designs, and additional variables such as work engagement, leadership style, digital readiness, organizational culture, and motivation to explain the remaining variance in employee performance.
Acknowledgment The authors express sincere gratitude to the Center for Health System Resilience Policy and the Health Policy Development Agency.
Ministry of Health of the Republic of Indonesia, for granting permission and providing administrative support for this References