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BONE MARROW TRANSPLANT patients pose challenges to achieving continuity of care, as they have complex needs, care is chronic, and patients cross numerous health care settings. Traditionally, bone marrow transplant centers have attempted to meet patient needs by separating needs into preadmission, inpatient, and outpatient and by hiring two to three nurses to work within each of those time periods. This paper describes how one CNS working with bone marrow transplant patients enlarged the role to incorporate functions typically performed by a coordinator position in order to better meet the needs of patients along the entire illness continuum. This paper outlines the principles necessary to implement the combined position, and the operationalization and analysis of the effectiveness of this approach in order to achieve continuity of care.