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Book review: One Small Step Can Change Your Life - The Kaizen Way, by Robert Maurer PhD

Review by Helen Miller, Macmillan Right By You Project Manager, University Hospitals of Morecambe Bay NHS Foundation Trust

Kaizen is an amalgamation of two Japanese words: “kai” meaning “change” and “zen” meaning ‘good’ that together translate as "good change" or "improvement." Toyota first introduced this Japanese philosophy in the 1980s. Kaizen has since come to mean "continuous improvement" through its lean methodology and principles.

The first words of the preface of this book are “Change is Hard!”. This sentiment resonates with so many and the book highlights the failure rate of “New Year’s Resolutions” as evidence.

However, the book emphasises that change “doesn’t have to be agonizingly painful”. Essentially the book highlights:

  • By making small steps, lasting change can be made

  • Kaizen can teach you to overcome resistance to new behaviour

“Ask yourself, ‘If health were my first priority, what would I be doing differently today? What is one way I can remind myself to drink more water? How could I incorporate a few more minutes of exercise into my daily routine?’”

“Small actions are at the heart of kaizen. By taking steps so tiny that they seem trivial or even laughable, you’ll sail calmly past obstacles that have defeated you before.”

The story of 'Julie' (page 17), highlights the positive application of Kaizen in a healthcare setting.

Julie was a single mum who was overweight with increasing health risks including high blood pressure, diabetes, heart disease and depression.

Rather than using the standard advice of increasing exercise and improving her diet, the physician in this case used the Kaizen approach and at the first consultation asked her to march on the spot in the front of the television for one minute a day.

Immediately Julie recognised that this was achievable and on her second consultation it was noticed that her attitude had changed and she was more animated confirming that she had, indeed, achieved the above goal, wanting to know what else she could do.

The physician then gradually encouraged her to increase her exercise minute by minute and within months she was willing to take on full aerobic exercise and her resistance had dissolved.

Prehabilitation (prehab) means getting ready for treatment in whatever time the patient has before treatment starts.

It is a programme of support and advice that covers diet, weight, physical activity and health and wellbeing e.g. smoking cessation, mental wellbeing.

Prehab aims to optimise a person’s health and wellbeing to help maximise their resilience to treatment throughout their journey. The benefits of prehab include improving cardiovascular fitness, nutrition, enhancing quality of life, which will enhance recovery. Prehab empowers people to take control of their health and wellbeing.

Macmillan’s strategy for prehab is supported by it’s publication 'Principles and guidance for prehabilitation within the management and support of people with cancer'.

Prehab as part of the rehabilitation pathway aligns strongly with Macmillan’s long-term ambitions including the personalised care agenda of Holistic Needs Assessment and care planning, supported self-management, joint decision making and integrated care.

This approach recognises the increasingly complex health and care landscape, “that 70% of people with cancer have other long term conditions to manage alongside cancer” and changes in treatment options resulting in more complex side effects.

The aims of this guidance are to advance cancer care provision, change practice and behaviour for the benefit of people living with cancer and to ensure prehab is understood and included in the development of cancer services as part of the whole cancer pathway.

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