Clinical Communication Response Latency as an Operational Efficiency and Patient Safety Indicator in Acute Care Hospitals.

OBJECTIVES: Timely clinical communication is a core safety function in acute care, yet response latency remains poorly measured. This study treats it as a stratified safety indicator and introduces a dual-phase model distinguishing verbal triage (T₀verbal) from physical intervention (T₀physical). METHODS: A mixed-methods observational design evaluated nurse call response latency across 3 anonymised hospitals: Hospital A (public, no-voice), Hospital B (private, no-voice), and Hospital C (private, voice-enabled). Voice-enabled systems provide 2-way audio between the patient and the nurse before arrival. A total of 16,000 call events across 9 departments were stratified by shift and acuity (NEWS2). Semistructured interviews contextualised patterns within the SEIPS 2.0 framework. Escalation was defined as a response time exceeding 180 seconds. RESULTS: Median response times were 29 seconds (voice-enabled), 130 seconds (private nonvoice), and 256 seconds (public nonvoice). The 90th-percentile response times were 60, 381, and 416 seconds, respectively. Escalation rates were 0.0%, 19.6%, and 70.3%. Ward night shift escalation in hospital A reached 76.0%. For patients with NEWS2 ≥7, medians were 28 seconds (voice-enabled) versus 80 to 88 seconds (nonvoice). Qualitative themes identified alarm fatigue, nonvalue-added locomotion, and coordination friction. CONCLUSIONS: Response latency, including tail latency, shift-stratified escalation, and the Surveillance Gap in nonvoice environments, may function as a leading indicator for safety monitoring. Voice-enabled communication may support workflow during low-staffing hours by narrowing the verbal-to-physical intervention interval and reducing nonvalue-added nursing locomotion. Findings are associative; institution type and communication modality were not fully separable.