173 Realist review of Midwife-Led Continuity of Care implementation (continued) Leadership Theory Context Mechanism Proximal outcome Supporting references Resource Response Change management Within maternity care networks, specific professional, organisational, and cultural norms prevail. Leadership styles, communication practices, and decision-making processes set the tone for how change initiatives like MLCC are perceived and embraced within the organisation. In maternity care networks with a culture of innovation, collaboration, and continuous learning, care providers may embrace change as an opportunity for growth and improvement. Open communication and opportunities for input ensures that the change process is inclusive, transparent, and responsive to care providers. Engagement from care providers, with the willingness and ability to embrace the changes brought about by MLCC. 13 15 18-22 25 26 29 30 33-36 38 39 In maternity care networks with a resistant and rigid culture, care providers may be accustomed to established roles and routines. They may exhibit reluctance or skepticism towards MLCC, fearing uncertainty, disruption to existing practices, loss of professional autonomy, or threats to their status within the hierarchy. Perpetuation of the status quo, hindering progress towards the implementation of MLCC. 6
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