Purpose
To validate the SiteWise survey as a reliable tool for assessing the accessibility of outpatient ophthalmology clinics for visually impaired patients and to compare accessibility between hospital-based and satellite clinics.
Methods
This quality improvement study, conducted from January to December 2023, used the SiteWise survey to assess design features in seven satellite and two hospital-based clinics within the Wilmer Eye Institute network. Independent surveyors evaluated elements such as parking, sidewalks, entrances, and interior areas. Reliability was measured using Krippendorf's alpha, and accessibility scores were compared using generalized estimated equations, analyses of variance, and
t
tests.
Results
The SiteWise survey demonstrated high reliability with a Krippendorf's alpha of 0.99. Hospital-based clinics had higher accessibility scores (mean 78.9%) compared to satellite clinics (mean 71.3%,
P
< 0.05). Areas such as hallways (mean 89%) and waiting areas (mean 87%) scored highest, whereas parking lots/sidewalks (mean 61%) and stairways (mean 61%) scored lowest, indicating significant room for improvement in these areas.
Conclusions
The SiteWise tool is reliable and effective in identifying accessibility deficiencies in outpatient ophthalmology clinics. Although indoor areas generally scored well, outdoor and transitional spaces require significant enhancements to improve accessibility for visually impaired patients.
Translational Relevance
This study bridges the gap between basic research and clinical care by providing a validated tool to assess and improve the accessibility of eye care facilities, ensuring they meet the needs of visually impaired patients.