Progress Monitoring
Regularly tracking the client’s progress towards their goals and making adjustments to the care plan as needed.
Evaluation of Outcomes
Assessing the effectiveness of the care plan and making recommendations for improvement.
Communication
Facilitating communication between the client, their family, and healthcare providers.
Resource Management
Connecting clients with relevant community resources, including financial assistance, housing, and legal services.
Discharge Planning
Assisting with the transition from one level of care to another, such as from hospital to home.