- Ensuring Continuity of Care: Coordinating care across different settings to provide consistent and effective treatment. - Reducing Hospital Readmissions: By providing thorough discharge planning and follow-up care, they help prevent unnecessary readmissions. - Enhancing Patient Education: Educating patients about their conditions and treatments leads to better self-management and adherence to care plans. - Facilitating Access to Resources: Connecting patients with community resources and support services that can aid in their recovery.