An institution or organization primarily a hospital requires competent employees because the work is related to a person's life. In accordance with one of the missions of the Banten Provincial Hospital "Improving the Competence and Quality of Human Resources through the Fulfillment of Professionally Trained and Educated Personnel", the Banten Provincial Hospital always maintains the competence of employees and existing human resources so that they are able to provide excellent and maximum service to their customers. public.

Dealing with competence itself refers to the characteristics that underlie the behavior that explains the motives, personal characteristics (characteristics), values, self-concept, knowledge or skills brought by someone who performs superiorly in the workplace (Palan, 2003). One of the efforts to improve employee competence is to conduct education and training. Training and development have various long-term career benefits that help employees to take on greater responsibilities in the future (Handoko, 2000).1 Training programs are important not only for individuals but also for organization and employee relations in work groups. Therefore, the easiest method to summarize the benefits of training is to realize that training is an organizational investment that is included in the realm of human resource management.

The quality of health services means being free to do everything professionally to improve the degree of health, comfort and service to patients and the community in accordance with advanced science and skills, quality equipment and transportation services for patients and families of good quality that meet good standards. Service quality is an important factor that can form customer trust in hospitals so as to create loyalty.

Currently, Indonesian people do not believe in the quality of hospital services. The idea of ​​improving the quality of quality is a challenge in a health care organization. Attempts to boost the quality of health services are the most important step to increase business competitiveness in the health sector (Sulastomo, 2006).2 The services provided by hospital employees are services that must prioritize the interests and safety of the patient, so as not to disappoint the patient's family. The services provided at the hospital include medical services, treatment and emergency services which are the most important services in the hospital. Emergency services include several components, including: communication systems, education, funding, Quality Control and transportation (ambulance). User satisfaction in ambulance transportation services is prioritized in improving the quality of hospital services. Improving the quality of ambulance services in hospitals according to Kepmenkes No. 143, concerning standardization of medical service vehicles. The need for standardization of general and medical equipment on ambulance vehicles, specifically for uniformity and improving the quality of medical emergency referral services, which are regulated by types of vehicles in hospitals, including: transportation ambulance, emergency ambulance, field hospital ambulance, mobile medical service ambulance and train corpse.

Training Process Mathis and Jackson (2006), the effective application of strategic training requires the use and a systematic training process, as illustrated by the chart above: first, assessment, training is made to aid the organization in achieving its goals. Therefore, the assessment of organizational training needs reflects the diagnostic stage of setting training objectives. Second, design, after the training objectives are determined, the training design can be completed. Third, delivery, after the training is designed, the delivery of the exercise can begin. Employee Competence Palan (2003) says competence is a skill and empowerment refer to the state or quality of being able and appropriate. Competence is an essential character of a person that indicates a way of behaving or thinking, which applies in a very wide range of situations and lasts for a long time.3

According to Hutapea and Thoha (2008), namely: Understanding this type of competence is acknowledged as Technical or Functional Competency (Technical/Functional Competency) or could also be called as Hard Skills/Hard Competency (hard competence). Dimensions and Main Components of Competence. Prihadi (2004) declared that the vital element of competence is an array of interrelated knowledge, attitudes, and abilities that affect most positions (roles or responsibilities), correlates with conduct in the position, and can be determined by acceptable standards, and could be enhanced over training and development efforts.4

Service Ratminto and Winarsi (2005), services are products that are invisible (cannot be touched) that involve human efforts and use equipment. The definition of service according to Kotler (1994) is: "A variety of actions or performances offered by one party to another that are basically invisible and do not result in property rights to something. Its production may or may not involve a physical product.” Dimensions of Service Quality One way to differentiate a service provider company is to consistently provide services of a higher quality than their competitors (Kotler, 1997). Ambulance User Satisfaction Tokunaga (2000), states that customer/patient satisfaction is one of the desired outcomes of hospital care where customers appraise service quality by comparing their perceptions of service with their expectations.5, 6, 7

The determination of vehicle standards in hospitals is prioritized to increase the satisfaction of ambulance service users. From the background above, the formulation of the research problem is as follows: 1. Is there an effect of training on the satisfaction of the families of ambulance users at the Banten Provincial Hospital? 2. Is there an effect of employee competence on the satisfaction of the family of ambulance users at the Banten Provincial Hospital? 3. Is there an indirect effect between training and employee competence with family satisfaction of ambulance users where service quality is an intervening variable?

The researcher used quantitative research using observational descriptive analytic using cross sectional with multivariate regression linier method. The population in this study were employees of the Banten Provincial Hospital for ambulance services and families who received services. The following is the study population table: The sample size for ambulance employees uses the entire population because the total number of ambulance employees is 25 (population less than 100). The instrument in this study uses a questionnaire or questionnaire, which is a number of written statements that are used to gain information from respondents in terms of personal reports or things that respondents know. The Likert scale formulation is designed in such a way as to allow respondents to answer with various levels of answers more freely. Thus, the answers to the instruments in the form of questions were given a score of 1-5 with the following conditions (Riduwan et al., 2011).8

Score Use of Questionnaire or Questionnaire

Table 0

No	Answers	Score
1.	Strongly Agree/Very Satisfied/Very Good/Very Important	5
2.	Agree/Satisfied/Good/Important	4
3.	Neutral/Sufficiently Satisfied/Medium/Sufficiently Important	3
4.	Disagree/Not Satisfied/Bad/Not Important	2
5.	Strongly Disagree / Dissatisfied / Very Bad / Not Important	1

source:Riduwan dan Kuncoro (2011)

The validity test is intended to test the accuracy of the details in the questionnaire and how far the tool can measure the thing or subject you want to measure.

The validity test is intended to test the accuracy of the details in the questionnaire and how far the tool can measure the thing or subject you want to measure.

Where the description of the formula is:

Where the description of the formula is:

X = Items score, for each questions N= Number of Sampel(Respondent)

Reliability Test The reliability test in this study used Cronbach's Alpha at the level of = 0.60 or more using the help of SPSS 17. The variable was declared reliable if the alpha was > 0.6.

The formula for Alpha Cronbach is as follows:

The formula for Alpha Cronbach is as follows:

The formula for Alpha Cronbach is as follows:

Data collection technique Data collection in this study used a survey method, where the research directly went to the research location, then used a questionnaire/questionnaire. Data analysis the problem of this research is Multivariate Variable Depending on Numerical, so that the data analysis uses the Multivariate Linear Regression method. Hypothesis test to simplify calculations, speed up the data analysis process and provide more accurate results, hypothesis testing in this study will be carried out using computer technology, namely the SPSS 17 program.

Reliability Test The test is carried out by means of One Shot (measurement only once) with SPSS Statistics 17, it is stated to be reliable if it gives a Cronbach Alpha value of 0.60. The following are the results of the reliability test for the job training variable (X1): Table 5.15 Reliability Test Results of Job Training Variables (X1)

In Table 5.15 it can be seen that the average Cronbach Alpha value of all statement items is 0.794> 0.60. So it can be stated that the overall statement is reliable.

Variab le of Employee Competence (X2)

The following are the results of the reliability test for the employee competency variable (X2): Table 1. Reliability Test Results of Employee Competency Variables (X2)

Table 0

Cronbach's Alpha	N of Rincians
.686	15

(Source: Result of SPSS )

In Table 5.16 it can be seen that the average Cronbach Alpha value of all statement items is 0.686> 0.60. So, it can be stated that all items of the statement are reliable. The following are the results of the reliability test for the Service Quality variable (Y1):

Table 1

Cronbach's Alpha	N of Rincians
.715	19

( Source: resultof SPSS )

Ambulance User Family Satisfaction Variable (Y2) The following are the results of the reliability test for the ambulance user satisfaction variable (Y2):

Table 2

Cronbach's Alpha	N of Rincians
.810	14

( Source: Resultof SPSS )

( Source: Result of SPSS )

In Table 5.18 it can be seen that the average Cronbach Alpha value of all statement items is 0.810> 0.60. So, it can be stated that the overall statement is reliable. Normality test Proof of this normality assumption will be carried out using Kolmogorov Smirnov in the SPSS 17 program, namely by looking at the significance (sig. Z), if the significance value (sig.Z) is greater than = 0.05, then the normality assumption has been met. The results of the assumption test are presented in the following table 4.

Table 3

Regression Equation	Sig.Z	Conclusion
Training Employee	0.634	Fulfilled Normality
Competence	0.397	Fulfilled Normality
Quality	0.625	Fulfilled Normality
Satisfaction	1.162	Fulfilled Normality

Linearity Test The linearity assumption test is carried out using Compare Means in the SPSS 17 program, then looks at the significance value of Linearity, if the significance value is less than 0.05, it can be said that the linearity assumption has been met. We recommend that if the significance value is more than 0.05 then the assumption of linearity has not been met, which means that there is no linear relationship between each research variable. The Influence of Job Training Variables (X1) and Employee Competence (X2) on Service Quality Variables (Y1). Table 5 describes the results of testing the influence of the Job Training variable (X1) and Employee Competence (X2) on Service Quality Variables (Y1) which is presented below

Table 4

Variable	Standardized Coefficients (Beta)	t-Count	P-Value (Sig.)
Training Employee	0.032	2.155	0.003
Competence	0.653	3.185	0.004
r2= 0.454	Critical Valuet-table = 1,708
KD=45.4

Table 5. shows that the results of testing the effect of job training variables (X1) and employee competence (X2) on service quality (Y1) have an Adjusted R Square (r2) of 0.454 and a coefficient of determination (KD) of 45.4. These results explain that the results of testing the influence of the job training variable (X1) and employee competence (X2) contributed 45.4% to the service quality variable (Y1). Based on the results of statistical calculations the effect of job training variable (X1) on service quality variable (Y1) shows tcount of 2.155, p-value of 0.003 and coefficient (beta) of 0.032. The results of the t test illustrate that tcount is greater than ttable (2.155>1.708). Based on the p-value where the calculation results show that the p-value (0.003) is smaller than significant. These results can be explained that the value of tcount is greater than tcount and the value of p-value is smaller than the significant value. The path coefficient value (beta) has a positive number, then the result is significant and positive. It is concluded that the job satisfaction variable (Y1) can be explained directly by the service quality variable (X1). The results of the statistical calculation of the employee competence variable (X2) on the service quality variable (Y1) show tcount of 3.185, p-value of 0.004 and path coefficient (beta) of 0.653. The results of t-test illustrate that tcount is greater than ttable (3.185>1.708 ). Based on the P-value where the calculation results show that the p-value is smaller than the significant value (0.004 <0.005). This result can be explained that the t-value is greater than the t-table and the p-value is smaller than the significance value. And the path coefficient value (beta) has a positive number, so the results are significant and positive. These results can be concluded, indicating that the service quality variable (Y1) can be explained directly by the employee competence variable (X2).

The Influence of Job Training Variables (X1), Employee Competence (X2) and Service Quality (Y1) on Satisfaction of ambulance user families (Y2) Table 5 describes the results of testing the effect of job training variables (X1), employee competence (X2) and service quality (Y1) on the satisfaction of ambulance users' families (Y2) which are presented below: Table 5.22 Path Coefficient Test Results of the Effect of Job Training Variables (X1), employee competence (X2) and service quality (Y1) on the satisfaction of ambulance user families (Y2).

Table 0

Variable	Standardized Coefficients (Beta)	t-Count	P-Value
Employee Training	0.028	2.227	0.003
Competence	0.777	5.128	0,000
Quality	0.189	1.753	0,001
r2= 0.805	Critical value t-table = 1,708
KD=80.5

Based on the results of data analysis and discussions that have been carried out, the results of this study can be concluded as follows: 1. The higher the job training, the higher the satisfaction of the family of ambulance users at the Banten Provincial Hospital 2. The higher the competence of employees, the higher the satisfaction of families using ambulances at the Banten Provincial Hospital 3. The higher the training and competence of employees, it will indirectly increase the Satisfaction of Ambulance User Families at the Banten Provincial Hospital through the quality of service as an intervening variable.