Why a Consistent TSA Process Matters for Vocational Rehabilitation Teams

A well-developed Transferable Skills Analysis brings together information about a person's work history, demonstrated abilities, education, restrictions or limitations, occupational requirements, and the labour market. The assessor must interpret that information and explain the reasoning behind the vocational options identified.

For an individual assessor, experience can provide much of the structure needed to complete this process.

For an organization, there is another question to consider:

What happens when several clinicians are completing TSAs within the same organization?

Do they follow a common methodology? Do they use occupational information consistently? Do their reports follow a similar structure? And when a new assessor joins the team, how do they learn the organization's approach?

These are important questions as vocational rehabilitation continues its transition to Canada's current occupational information systems, including the National Occupational Classification (NOC) and the Occupational and Skills Information System (OaSIS).

Consistency supports clinical judgement

Standardization can sometimes sound as though every assessment should produce the same answer. However, Transferable Skills Analysis requires professional judgement and two clients with similar employment histories may have very different abilities, restrictions, education, interests, circumstances and vocational possibilities. A structured process simply provides a consistent framework within which professional judgement can be applied.

For example, an organization can establish a common approach to:

• gathering and reviewing relevant client information
• analysing past occupations
• identifying demonstrated occupational abilities
• using NOC and OaSIS information
• considering physical, cognitive and other occupational demands
• identifying potential occupational options
• conducting labour market research
• documenting the rationale for recommendations.

 The conclusions continue to remain individualized, while the process used to reach them becomes more consistent.

Why does consistency matter across a team?

Variation is inevitable when professionals work independently.

While some variation reflects the use of clinical reasoning and subtle differences between clients, other variation can come from differences in training, experience, terminology, information sources or documentation habits.

For an organization providing vocational rehabilitation services, too much process variation can create practical challenges.

Reports may require additional review. New clinicians may need considerable support from experienced assessors. Different team members may interpret occupational information differently. The organization may also find it difficult to explain its TSA methodology when there is no clearly defined process shared across the team.

Research from other areas of rehabilitation provides some useful insight.

A recent study examined the implementation of a standardized cognitive assessment protocol for occupational therapists and speech-language pathologists in outpatient rehabilitation. The implementation included clinician education and training, as well as standardized documentation templates. The templates were designed to support consistent documentation, workflow and clinical decision-making. Training continued as part of onboarding for new staff. The researchers concluded that standardized practice protocols can be implemented in rehabilitation settings, while also noting that organizational support and attention to workflow are important to successful adoption.¹

The study was not about Transferable Skills Analysis. However, the underlying organizational principle is relevant: a defined methodology, supported by education and documentation tools, can provide clinicians with a common framework for practice.

The hidden administrative work in a TSA

There is another reason to look closely at TSA processes: the amount of administrative work surrounding the clinical analysis.

Consider the individual steps involved in completing a TSA.

An assessor may need to locate occupational profiles, review multiple descriptors, compare occupational requirements, record findings, search for potential occupations, transfer information into working documents and then organize the relevant information for the final report.

Each step may be reasonable on its own. Together, they can consume a significant part of the assessment process.

Documentation burden is increasingly being examined in rehabilitation practice.

A 2024 qualitative study of outpatient rehabilitation therapists, including occupational therapists, explored clinicians' experiences with electronic documentation. Therapists described documentation as affecting clinical time and work-life balance. Manual data entry was identified as a burden, and clinicians prioritized strategies such as time-saving templates, simpler interfaces and improved documentation processes.²

Again, this research was not specific to vocational rehabilitation or TSA. It does raise a useful question for vocational rehabilitation organizations:

How much of the TSA process requires professional reasoning, and how much involves finding, sorting, transferring and formatting information?

Technology is most useful when it supports the second group of tasks while leaving professional reasoning with the assessor.

A structured process can also support onboarding

Experienced TSA assessors develop considerable knowledge over time.

They learn which questions to ask. They become familiar with occupational classifications. They develop ways of interpreting work history, restrictions and occupational demands. They also learn how to explain why an occupation was, or was not, considered appropriate.

The challenge for an organization is transferring that knowledge to someone new.

Without a defined process, onboarding may depend heavily on one experienced clinician teaching another clinician how they personally complete a TSA.

A structured approach creates a different starting point.

New clinicians can learn:

• the stages of the assessment
• what information should be considered at each stage
• how occupational information is used
• where professional judgement is required
• how conclusions should be documented

Supervision remains important. The difference is that the supervisor and learner are working from the same framework.

This becomes particularly relevant for organizations trying to develop capacity in vocational rehabilitation without expecting every new clinician to develop a TSA methodology independently.

Current occupational information adds another reason for consistency

Canadian vocational rehabilitation practice is also experiencing an important change in occupational information. OaSIS provides occupational competency and work-requirement information linked to the NOC. As organizations transition from Career Handbook concepts and other legacy approaches, teams need to decide how current NOC and OaSIS information will be incorporated into their assessments.

The practice decisions remain:

• Which OaSIS descriptors are relevant to TSA?
• How should previous occupations be analysed?
• How should demonstrated abilities be compared with potential occupations?
• How should occupational requirements be documented?

If every clinician answers these questions independently, organizations may simply replace one source of occupational information with another while retaining substantial variation in methodology.

A shared TSA process can help an organization establish how current Canadian occupational information will be used across the team.

From individual expertise to an organizational process

Experienced clinicians will always be important to high-quality vocational assessment. The opportunity is to make their expertise easier to teach, apply and sustain across an organization.

A consistent TSA system can provide the framework. Education can teach the methodology. Digital tools can reduce some of the repetitive work involved in accessing, organizing and documenting occupational information.

Professional judgement remains with the assessor.

For organizations reviewing their TSA services, a useful starting point may therefore be a simple question:

If several clinicians completed similar TSA referrals tomorrow, would they be following the same underlying process?

The answer can reveal a great deal about training, workflow, documentation and the sustainability of the service.

A structured approach to TSA

The Transitions Vocational Assessment approach combines TSA education with the TransitionsApp to provide a structured methodology for completing Transferable Skills Analysis using current Canadian NOC and OaSIS occupational information.

The education program teaches the assessment process, including referral review, client assessment, vocational analysis, use of occupational information, labour market analysis and report preparation.

The TransitionsApp supports that process by bringing NOC and OaSIS information into a structured TSA workflow and providing tools for occupational analysis and reporting.

For organizations, the objective is not to replace professional judgement. It is to give clinicians a common process in which to apply it.

Learn more about Transitions Vocational Assessment and TransitionsApp

References

1. Tierney-Hendricks C, et al. Using the RE-AIM and TDF frameworks to evaluate the implementation of a standardized cognitive assessment protocol in outpatient rehabilitation. PM&R. Published online 2024. doi:10.1002/pmrj.13250.
2. Schwartz-Dillard J, Ng T, Villegas J, Johnson D, Murray-Weir M. Electronic documentation burden among outpatient rehabilitation therapists: a qualitative descriptive study and quality improvement initiative. Journal of the American Medical Informatics Association. 2024;31(10):2347-2355. doi:10.1093/jamia/ocae192.
3. Employment and Social Development Canada. Occupational and Skills Information System (OaSIS). Government of Canada. https://noc.esdc.gc.ca/Oasis/OasisWelcome
4. Employment and Social Development Canada. National Occupational Classification (NOC). Government of Canada. https://noc.esdc.gc.ca/