When multiple impairments exist, how should you approach priority setting in a PT plan of care?

• A. Address the easiest impairment first to maximize speed
• B. Prioritize based on patient goals, safety, and functional impact; use problem-importance ranking
• C. Follow a random order of impairments to avoid bias
• D. Only treat impairments that have objective measurements

Answer: (B)

Prioritizing care when several impairments are present centers on safety, functional impact, and what the patient wants to achieve, organized with a problem-importance ranking. Start by listing each impairment and judging how much it affects safety (falls or injury risk), basic daily activities, and the ability to participate in important tasks or roles. Then integrate the patient’s goals with these impact assessments to determine which issues will help the patient move closest to meaningful outcomes. By ranking problems this way, you allocate the most time and resources to areas with the greatest potential to improve safety and independence, given the patient’s priorities.

For example, a balance deficit that increases fall risk at home often takes precedence because it directly affects safety and daily functioning, especially if the patient’s goal is to remain independent at home. Endurance or strength issues may be tackled next, once the immediate safety concerns are addressed, aligning progression with the patient’s goals as well.

This approach contrasts with choosing the easiest impairment first, which can miss safety needs or goals; relying only on objective measurements can ignore what matters most to the patient in real life; and following a random order ignores risk and functional impact altogether.