Dr Kylie Wales

Dr Kylie Wales

Lecturer

School of Health Sciences

Personalised therapy pays off for everyone

Dr Kylie Wales is reimagining how we assess clients’ individual occupational therapy needs, helping to improve their safety and life outcomes.

Kylie’s research is as empathetic as it is financially strategic, exploring how better assessment can help occupational therapists meet clients’ goals more effectively. This not only provides better value for the client, but also for the healthcare system.

“My research helps contribute to better client outcomes and safety through accurate assessment and focussed service delivery,” Kylie explains.

“This allows us to benchmark best practice and understand if we are achieving client goals. In other words, I research whether what we do as occupational therapists actually works!

“Measuring the effects of practices can help determine what occupational therapy interventions are effective and cost-effective. Then we know where health funds should be invested—creating more bang for your buck, so to speak.”

Ultimately, Kylie’s work is about getting the right therapy plan to the right person. By making therapy more individualised, clients can expect increased safety and better results.

“Not everyone is the same, so we shouldn’t treat them the same. There are also multiple ways to approach every challenge, so it’s really about finding out what best suits the client. The right approach can make all the difference in the world for them.”

Kylie’s research insights are sought-after. A recent systematic review titled “Functional Assessments Used by Occupational Therapists with Older Adults at Risk of Activity and Participation Limitations” was in the top one per cent of PLOS ONE’s most downloaded articles.

Far from being confined to the shelves, Kylie’s research is helping to influence occupational therapy practice nationwide. Her insights are empowering decision makers to allocate funding to treatments that both work and are cost-effective. One of her projects is helping to inform the use of standardised assessments in billable healthcare environments.

Recently, Kylie was acknowledged as one of the University of Newcastle’s up-and-coming researchers when she was invited to participate in the University’s ThinkWell Early and Mid-Career Women’s Development Program. Facilitated through the Faculty of Health and Medicine's Gender Equity Committee, the program targets high potential academics to build future research leaders.

For Kylie, that next stage includes working with Higher Degree Research students and building research and industry collaborations that take her innovative work global. Ultimately the goal is to progress the occupational therapy field.

“Alongside my research, I also love teaching; it gives me a great sense of achievement to see students develop their occupational therapy identities, gaining knowledge, skills and expertise. Turning out the best future occupational therapists possible is a very important part of the job.”

Kylie is a member of Occupational Therapy Australia, a previous Australian Post-Graduate Award winner and recipient of the Centre of Excellence in Population Ageing Research (CEPAR) Scholarship.

Personalised therapy pays off for everyone

Dr Kylie Wales is reimagining how we assess clients’ individual occupational therapy needs, helping to improve their safety and life outcomes.Kylie’s research is as empathetic as it is financially strategic, exploring how better assessment can help occupational therapists meet clients’…

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Career Summary

Biography

Kylie started working with the University of Newcastle in 2017 as a lecturer and course coordinator for practice education in occupational therapy, roles that bring together her firm love for teaching and zest for research and discovery. Kylie’s research explores health economics, ageing and psychometrics. Together with her team, she seeks to understand how occupational therapists can access their clients’ situation and needs so they can provide the most effective—and cost-effective—treatments that improve people’s quality of life. 

Kylie completed her undergraduate degree with the University of Western Sydney, graduating with first class honours and Dean’s merit list credit. After graduation, Kylie worked in Western Sydney as a community occupational therapist for young adults with lifelong conditions. The role predominately focused on equipment prescription, home modifications and life skills. A year later, Kylie’s growing interest in research propelled her into a project manager position for a research study funded by the National Health and Medical Research Council. The study’s investigations highlighted serious gaps in our understanding of occupational therapists’ role in discharge planning.

Determined to investigate these knowledge gaps, Kylie commenced a PhD in 2011 with the University of Sydney, supported by an Australian Post-Graduate Scholarship. Kylie’s research focused specifically on understanding clients’ needs and outcomes in the hospital setting and the cost-effectiveness of discharge planning practice. Kylie combined her research studies with a post-graduate teaching fellowship, gaining valuable experience in teaching both undergraduate and masters students about equipment prescription, home modifications, falls prevention, ageing, and evidence-based practice.

For her PhD, Kylie ran a study at John Hunter Hospital, evaluating the application of assessment tools on older adults who were admitted to acute hospital care. She then moved into clinical work with Vision Australia, becoming the Regional Practice Lead for the Central Coast and Hunter Regions. Kylie was core to leading the allied health team through the change in service delivery under My Aged Care and National Disability Insurance Scheme.



Qualifications

  • Doctor of Philosophy, University of Sydney
  • Bachelor of Applied Science (Occupational Therapy), University of Western Sydney

Keywords

  • Ageing
  • Cost-effectiveness
  • Measurement
  • Occupational Therapy

Fields of Research

Code Description Percentage
111702 Aged Health Care 40
111717 Primary Health Care 30
111708 Health and Community Services 30

Professional Experience

UON Appointment

Title Organisation / Department
Lecturer University of Newcastle
School of Health Sciences
Australia

Teaching

Code Course Role Duration
OCCT2254 Beginning Occupational Therapy Professional Practice
The Faculty of Health Science / The University of Newcastle / Australia
Course Coordinator 24/08/2017 - 24/09/2047
OCCT4273 Advanced Occupational Therapy Practice
The Faculty of Health Science / The University of Newcastle / Australia
Course Coordinator 24/08/2017 - 24/09/2047
OCCT3161 Intermediate Occupational Therapy Professional Practice
The Faculty of Health Science / The University of Newcastle / Australia
Course Coordinator 24/08/2017 - 24/09/2047
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Publications

For publications that are currently unpublished or in-press, details are shown in italics.


Chapter (1 outputs)

Year Citation Altmetrics Link
2017 Cordier R, Joosten A, Clemson L, Wales K, 'The development of occupations across the lifespan', Occupational Therapy in Australia Professional and Practice Issues, Allen & Unwin, Crows Nest 244-259 (2017)

Journal article (10 outputs)

Year Citation Altmetrics Link
2018 Pike S, Lannin NA, Wales K, Cusick A, 'A systematic review of the psychometric properties of the Action Research Arm Test in neurorehabilitation.', Australian occupational therapy journal, 65 449-471 (2018) [C1]
DOI 10.1111/1440-1630.12527
Citations Scopus - 1
2018 Unsworth CA, Timmer A, Wales K, 'Reliability of the Australian Therapy Outcome Measures for Occupational Therapy (AusTOMs-OT)', Australian Occupational Therapy Journal, 65 376-386 (2018) [C1]
DOI 10.1111/1440-1630.12476
Citations Scopus - 2Web of Science - 1
2018 Wales K, Salkeld G, Clemson L, Lannin NA, Gitlin L, Rubenstein L, et al., 'A trial based economic evaluation of occupational therapy discharge planning for older adults: the HOME randomized trial', Clinical Rehabilitation, 32 919-929 (2018) [C1]

© 2018, The Author(s) 2018. Objective: To compare the cost effectiveness of two occupational therapy¿led discharge planning interventions from the HOME trial. Design: An economic ... [more]

© 2018, The Author(s) 2018. Objective: To compare the cost effectiveness of two occupational therapy¿led discharge planning interventions from the HOME trial. Design: An economic evaluation was conducted within the superiority randomized HOME trial to assess the difference in costs and health-related outcomes associated with the enhanced program and the in-hospital consultation. Total costs of health and community service utilization were used to calculate incremental cost-effectiveness ratios, activities of daily living and quality-adjusted life years. Setting: Medical and acute care wards of Australian hospitals (n=5). Subjects: A total of 400 people = 70 years of age. Interventions: Participants were randomized to either (1) an enhanced program (HOME), involving pre/post discharge visits and two follow-up phone calls, or (2) an in-hospital consultation using the home and community environment assessment and the Lawton Instrumental Activities of Daily Living assessment. Main measures: Nottingham Extended Activities of Daily Living (global measure of activities of daily living) and SF-12V2, transformed into SF-6D (quality-adjusted life year) measured at baseline and three months post discharge. Results: The cost of the enhanced program was higher than that of the in-hospital consultation. However, a higher proportion of patients showed improvement in activities of daily living in the enhanced program with an incremental cost-effectiveness ratio of $61,906.00 per person with clinically meaningful improvement. Conclusion: Health services would not save money by implementing the enhanced program as a routine intervention in medical and acute care wards. Future research should incorporate longer time horizons and consider which patient groups would benefit from home visits.

DOI 10.1177/0269215518764249
2018 Wales K, Lannin NA, Clemson L, Cameron ID, 'Measuring functional ability in hospitalized older adults: a validation study', DISABILITY AND REHABILITATION, 40 1972-1978 (2018)
DOI 10.1080/09638288.2017.1323021
2016 Clemson L, Lannin NA, Wales K, Salkeld G, Rubenstein L, Gitlin L, et al., 'Occupational Therapy Predischarge Home Visits in Acute Hospital Care: A Randomized Trial', JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 64 2019-2026 (2016)
DOI 10.1111/jgs.14287
Citations Scopus - 9Web of Science - 6
2016 Wales K, Clemson L, Lannin N, Cameron I, 'Functional Assessments Used by Occupational Therapists with Older Adults at Risk of Activity and Participation Limitations: A Systematic Review', PLOS ONE, 11 (2016)
DOI 10.1371/journal.pone.0147980
Citations Scopus - 14Web of Science - 12
2015 Pike S, Lannin NA, Cusick A, Wales K, Turner-Stokes L, Ashford S, 'A systematic review protocol to evaluate the psychometric properties of measures of function within adult neuro-rehabilitation', Systematic Reviews, 4 (2015)

© 2015 Pike et al. Background: Spasticity in the upper limb is common after acquired brain impairment and may have a significant impact on the ability to perform meaningful daily ... [more]

© 2015 Pike et al. Background: Spasticity in the upper limb is common after acquired brain impairment and may have a significant impact on the ability to perform meaningful daily activities. Traditionally, outcome measurement in spasticity rehabilitation has focused on impairment, however, improvements in impairments do not necessarily translate to improvements in an individual's ability to perform activities or engage in life roles. There is an increasing need for outcome measures that capture change in activity performance and life participation. Methods/Design: We will conduct a systematic review of the psychometric properties of instruments used to measure upper limb functional outcomes (activity performance and participation) in patients with spasticity. Assessments (n = 27) will be identified from a recently published systematic review of assessments that measure upper limb function in neurological rehabilitation for adults with focal spasticity, and a systematic review of each assessment will then be conducted. The databases MEDLINE, CINAHL and EMBASE will be searched from inception. Search strategies will include the name of the assessment and the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) published search strategy for identifying studies of measurement properties. The methodological rigour of the testing of the psychometric quality of instruments will be undertaken using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. International Classification of Functioning, Disability and Health (ICF) definitions of impairment, activity and participation will be used for content analysis of items to determine the extent to which assessments are valid measures of activity performance and life participation. We will present a narrative synthesis on the psychometric properties and utility of all instruments and make recommendations for assessment selection in practice. Discussion: This systematic review will present a narrative synthesis on the psychometric properties and utility of assessments used to evaluate function in adults with upper limb focal spasticity. Recommendations for assessment selection in practice will be made which will aid clinicians, managers and funding bodies to select an instrument fit for purpose. Importantly, appropriate assessment selection will provide a mechanism for capturing how applicable to everyday life the outcomes from individualised rehabilitation programs for the upper limb really are.

DOI 10.1186/s13643-015-0076-5
Citations Scopus - 3Web of Science - 3
2013 Laver K, Wales K, Clemson L, 'Effectiveness of pre-discharge occupational therapy home visits has yet to be evaluated; a definitive trial is feasible and warranted', Australian Occupational Therapy Journal, 60 374-375 (2013)
DOI 10.1111/1440-1630.12086
2012 Wales K, Clemson L, Lannin NA, Cameron ID, Salked G, Gitlin L, et al., 'Occupational therapy discharge planning for older adults: A protocol for a randomised trial and economic evaluation', BMC GERIATRICS, 12 (2012)
DOI 10.1186/1471-2318-12-34
Citations Scopus - 5Web of Science - 4
2012 Wales K, Clemson L, Lannin NA, Cameron ID, 'Functional assessments used by occupational therapists with older adults at risk of activity and participation limitations: A systematic review and evaluation of measurement properties', Systematic Reviews, 1 (2012)

Background: Older adults experience activity and participation limitations that are associated with ageing. Activity and participation limitations affect an older adult's abi... [more]

Background: Older adults experience activity and participation limitations that are associated with ageing. Activity and participation limitations affect an older adult's ability to engage in meaningful daily activities and valued life roles. Occupational therapists provide interventions to reduce such limitations and monitor client change to ensure that interventions are effective. Client change should be measured through the use of valid and reliable assessments. Yet occupational therapists can favour the use of non-standardised assessments leading to inaccurate reflections of client change and difficulties in comparing the effectiveness of interventions. A number of reasons have been suggested as to why therapists may favour non-standardised assessments, including a lack of knowledge (of assessments and their properties) and lack of skill.Methods/design: This paper describes the systematic review protocol that will be used to identify functional assessments used in randomised trials of occupational therapy interventions for older adults (=70 years of age). Interventions will focus on enhancing functional independence for either older adults transitioning from hospital to home, or community dwelling older adults. We will search Medline, EBSCO and OTseeker using a pre-determined search strategy to identify Functional assessments. These assessments will be recorded and, in phase two, their measurement properties analysed.Discussion: This protocol provides a comprehensive guideline for conducting the proposed systematic review. The results of this systematic review will provide a thorough and unbiased identification and evaluation of measurement properties of functional assessment tools used in randomised trials to evaluate occupational therapy intervention. This information can be used to determine which assessment has superior measurement properties and will inform occupational therapy practice. © 2012 Wales et al.; licensee BioMed Central Ltd.

DOI 10.1186/2046-4053-1-45
Citations Scopus - 3
Show 7 more journal articles

Conference (16 outputs)

Year Citation Altmetrics Link
2017 Cameron L, Casey A, Wales K, Pike S, Lannin NA, 'A systematic review of instruments used to measure the self-reported quality of life of stroke survivors' (2017)
2017 Pike S, Lannin NA, Cusick A, Wales K, 'A systematic review of the psychometric properties of the upper-limb motor assessment scale and its ability to measure everyday activity performance' (2017)
2017 Pike S, Lannin N, Cusick A, Wales K, 'Measuring everyday activity performance and life participation: A systematic review of the psychometric properties of the nine-hole peg test' (2017)
2017 Wales K, Clemson L, Lannin NA, 'Economic analysis in occupational therapy: The role of research in ensuring our continued funding' (2017)
2017 Wales K, Wesson J, Clemson L, Lannin NA, 'Occupational therapy measurement with older adults: What are we doing and why? [Poster]' (2017)
2015 Pike S, Lannin NA, Cusick A, Wales K, Ashford S, Turner-Stokes L, 'A systematic review of measurement properties of functional assessment including their validity as measures of everyday activity performance and life participation' (2015)
2015 Wales K, Clemson L, Lannin NA, Cameron I, 'Selecting psychometrically robust functional assessment for use with older adults: A systematic review' (2015)
2015 Coulter M, Lannin NA, Eyres L, Stevenson M, Wales K, Willman A, Clemson L, 'Do our acute occupational therapy functional assessments predict home performance in older Australians?' (2015)
2015 Clemson L, Lannin N, Wales K, Gitlin L, Rubenstein L, Barris S, et al., 'Occupational therapy discharge planning to facilitate transition from hospital to home: The HOME trial' (2015)
2015 Wales K, Lannin NA, Clemson L, 'Measuring functional ability inacute hospitalised older adults: A validation and reliability study' (2015)
2015 Clemson LM, Lannin N, Wales K, Gitlin LN, Rubenstein L, Cameron ID, 'DISCHARGE PLANNING UTILIZING HOME VISITS COMPARED TO IN-HOSPITAL CONSULTATION, EFFECTS ON COST UTILIZATION, FUNCTION AND PARTICIPATION: THE AUSTRALIAN HOME TRIAL', GERONTOLOGIST (2015)
2014 Wales K, Clemson L, Lannin NA, Cameron I, 'A systematic review of measurement properties of the Assessment of Motor and Process Skills' (2014)
2014 Wales K, Clemson L, Lannin NA, Cameron I, 'Occupational therapy HOME discharge planning for older adults: Is this a cost effective practice?' (2014)
2013 Wales K, Clemson L, Lannin NA, Cameron ID, 'Measuring activity and participation limitations in older adults: A systematic review and evaluation of measurement properties' (2013)
2013 Clemson L, Davies C, Wales K, Lannin NA, Jang H, 'Collaborative goal setting as core to occupational therapy discharge planning for at-risk older adults: A content analysis explores the goals' (2013)
2013 Clemson LM, Lannin N, Wales K, Gitlin LN, Cameron ID, Rubenstein L, 'PREPARING OLDER ADULTS FOR SSFE DISCHARGE AND RESUMPTION OF MEANINGFUL DAILY ACTIVITIES: THE HOME INTERVENTION', GERONTOLOGIST (2013)
Show 13 more conferences
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Grants and Funding

Summary

Number of grants 2
Total funding $8,863

Click on a grant title below to expand the full details for that specific grant.


20182 grants / $8,863

Measurement in occupational therapy: Assessment of function and evaluation of outcomes$4,924

This funding will be used to design and implement a survey related to the use of standardised assessments in billable clinical environments including the NDIA.

Funding body: School of Health Sciences Strategic Pilot Funding

Funding body School of Health Sciences Strategic Pilot Funding
Project Team

Dr Kylie Wales, Dr Jacki Wesson & A/Professor Natasha Lannin

Scheme School of Health Sciences Strategic Pilot Funding
Role Lead
Funding Start 2018
Funding Finish 2018
GNo
Type Of Funding Internal
Category INTE
UON N

Systematic Review of economic evluations of occupational therapy services for adults within acute and sub-acute care$3,939

The aim of this systematic review is to determine the cost-effectiveness of occupational therapy services provided within acute and sub-acute care.

Funding body: School of Health Sciences Strategic Pilot Funding

Funding body School of Health Sciences Strategic Pilot Funding
Project Team

Dr Kylie Wales, Miia Rahja, Dr Kate Laver, Danielle Lang, Lisa Somerville & A/Professor Natasha Lannin

Scheme School of Health Sciences Strategic Pilot Funding
Role Lead
Funding Start 2018
Funding Finish 2018
GNo
Type Of Funding Internal
Category INTE
UON N
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Research Supervision

Number of supervisions

Completed0
Current1

Current Supervision

Commenced Level of Study Research Title Program Supervisor Type
2018 PhD Sustainability of adult children support and care for older people in Ghana Health, Faculty of Health and Medicine, University of Newcastle Co-Supervisor
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Dr Kylie Wales

Position

Lecturer
School of Health Sciences
Faculty of Health and Medicine

Contact Details

Email kylie.wales@newcastle.edu.au
Phone (02) 4921 7875

Office

Room HA-28
Building Hunter Building
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