About

Jennifer Ouellet, MD, is an Associate Professor of Medicine in Geriatrics at Yale School of Medicine. She specializes in the care of older adults with multiple chronic illnesses, focusing on optimizing mental status, mobility, and medication management to help patients achieve what matters most to them in the context of their health care. Dr. Ouellet spends most of her clinical time caring for older adults in the hospital setting and emphasizes building relationships with patients and their caregivers to support their health goals. Her research interests include patient priorities care, decision-making for persons with multiple chronic conditions, and medical education related to geriatrics. She has contributed to developing curricula for internal medicine residents, particularly in priorities-aligned decision-making and high-value care for older adults. Dr. Ouellet is actively involved in professional organizations such as the American Geriatrics Society, where she participates in the Patient Priorities Care Special Interest Group and intern selection committees. Her work aims to improve health outcomes for older adults through clinical care, education, and research.

Research topics

• Medicine
• Gerontology
• Political Science
• Psychology
• Nursing
• Psychiatry
• Family medicine

Selected publications

• Adapting the 4Ms Framework for American Indian and Alaska Native Communities

  Innovation in Aging · 2025-12-01

  articleOpen accessSenior author

  Abstract The 4Ms (Matters Most, Medication, Mentation/Mind, Mobility) provide a valuable framework for older individuals, and their caregivers and clinicians, for consideration of factors influencing health, daily function, and well-being. Through an iterative process involving internal discussions and external listening sessions including tribal organizations, brain health advocates and experts, we sought to adapt the language and visual imagery associated with the 4Ms to be more relatable and relevant to American Indian and Alaska Native communities. The final version reflects the individual 4M components and also incorporates cultural elements: a tree at the center, roots representing traditional core values, branches representing the 4Ms, and leaves depicting the daily activities and expressions of the 4Ms. The resulting visual images and terms can be further modified and adapted to reflect local tribal geographic elements, language, and traditions.

  PublisherOA PDFDOI

• Age Friendly Health System 4M Competency-Based Curriculum for Internal Medicine Residents

  Innovation in Aging · 2025-12-01

  articleOpen accessSenior author

  Abstract The Age Friendly Health System 4Ms is an evidence-based framework to provide high value care to older adults, with which educational content in Geriatrics is increasingly aligned. Focusing on Internal Medicine residents, who provide care to older adults in a variety of settings, we aimed to assess perceived proficiency in core competencies, as identified by AGS/ADGAP and organized using the 4Ms framework. We surveyed Internal Medicine residents in three programs at one academic medical center. The survey asked residents about their self-reported proficiency in AGS/ADGAP competencies on a scale of 1-5 (1 “completely unable to perform this skill”, 5 “I am expert and can teach this skill to others”). A total of 35 residents responded to the pre-curriculum survey, including 13 PGY1, 17 PGY2 and 5 PGY3 residents. Most (71%) had no Geriatrics-focused experience in medical school, yet 27 individuals (77%) had >1 Geriatrics rotation during residency. Residents self-reported lower proficiency scores in competencies related to mobility (3.21) and multicomplexity (3.39). Of the competencies, residents scored lowest in their ability to screen for pressure injuries (2.95) and develop a multifaceted plan for fall prevention (3.00). Our findings highlight gaps in Internal Medicine residents’ self-reported proficiency in key Geriatrics competencies. These results will inform our development of a QR-generated skills tracker for residents to have skills in Geriatrics evaluated in real time by trained faculty. This will also help align curricular content in didactics and rotations to target highest priority learning needs.

  PublisherOA PDFDOI

• Alignment of the ACGME milestones for internal medicine and family medicine residents with a curriculum in priorities-aligned decision-making

  Academic Medicine · 2025-12-31

  article1st authorCorresponding

  PROBLEM: Clinical decision-making for persons with multiple chronic conditions is a challenge because of uncertain benefits and harms of many treatments and variability in what health outcomes are most important to patients. Patient Priorities Care (PPC) is an evidence-based approach to aligning decision-making for persons with multiple chronic conditions with their own health priorities. Curricula for health professional trainees in the PPC approach would equip them with the skills necessary to optimize care for this complex population. However, given the time limitations during medical training, program leadership must prioritize competency-based medical education. The authors determined alignment of internal medicine (IM) resident and family medicine (FM) resident Accreditation Council for Graduate Medical Education (ACGME) milestones with core PPC skills. APPROACH: From June 2023 through December 2023, PPC at 3 academic institutions examined ACGME milestones for IM and FM residents and identified milestones that overlap with core PPC skills. Then from June 2024 through December 2024, US Program Directors within IM (S.S.) and FM (M.M.B.) reviewed the findings. OUTCOMES: The 8 core skills of PPC align with 13 of the 21 IM ACGME milestones and 10 of the 19 FM ACGME milestones. PPC addresses ACGME IM/FM milestones in patient care, medical knowledge, systems-based practice, practice-based learning and improvement, and interpersonal and communication skills. A pilot PPC curriculum with IM residents demonstrated increased confidence in several core PPC skills. NEXT STEPS: After demonstrating milestone alignment, authors are developing educational materials for use in various clinical and educational settings with trainees and also practicing health professionals. Tools to assess skills will be created to guide medical educators who implement the PPC trainings. Following that, authors will work with key stakeholders including IM and FM residents, program directors, and geriatrician clinician-educators to assess the feasibility of implementing a PPC curriculum throughout residency training.

  PublisherDOI

• What Matters Most: An Example of Implementing Patient Priorities Care

  The Senior Care Pharmacist · 2025-07-01 · 1 citations

  articleSenior author

  This is the first in a series of Age-Friendly case studies developed as a function of the John A. Hartford Foundation grant to the American Society of Consultant Pharmacists and the Peter Lamy Center on Drug Therapy and Aging at the University of Maryland School of Pharmacy to Leverage Pharmacists as Age-Friendly 4Ms Champions. This series presents a case for each of the 4Ms: What Matters, Medication, Mentation, and Mobility, and examines how these elements interrelate to optimize care for older patients. This report involves adopting the 4Ms Framework of an Age-Friendly Heath System (What Matters, Medication, Mentation, and Mobility) in combination with the Patient Priorities Care (PPC) approach for a female patient with multiple chronic conditions. PPC supports patients and care teams in aligning health care decisions with what matters most to the patient. While applicable to all patients, it is particularly valuable for older patients with multiple chronic conditions, such as the patient in this case.The authors sought to identify what matters most to the patient, specifically her desires to spend more time with her grandchildren, volunteer in her community, and maintain independence in mobility. They then worked with the care team to determine how best to support those goals.Fatigue was identified as the greatest barrier. The team evaluated potential interventions to reduce the patient’s fatigue, considering their risks, benefits, relative likelihood of effect, and feasibility. After engaging in collaborative decision-making with the patient, the team selected an intervention and followed up to assess its impact on the patient’s ability to achieve her goals.This case illustrates how the PPC approach can help operationalize patient-centered care by aligning clinical decisions with what matters most to older adults with multiple chronic conditions.

  PublisherDOI

• Age Friendly Health System 4M Competency-Based Curriculum for Internal Medicine Residents

  Innovation in Aging · 2025-12-01

  articleOpen accessSenior author

  Abstract The Age Friendly Health System 4Ms is an evidence-based framework to provide high value care to older adults, with which educational content in Geriatrics is increasingly aligned. Focusing on Internal Medicine residents, who provide care to older adults in a variety of settings, we aimed to assess perceived proficiency in core competencies, as identified by AGS/ADGAP and organized using the 4Ms framework. We surveyed Internal Medicine residents in three programs at one academic medical center. The survey asked residents about their self-reported proficiency in AGS/ADGAP competencies on a scale of 1-5 (1 “completely unable to perform this skill”, 5 “I am expert and can teach this skill to others”). A total of 35 residents responded to the pre-curriculum survey, including 13 PGY1, 17 PGY2 and 5 PGY3 residents. Most (71%) had no Geriatrics-focused experience in medical school, yet 27 individuals (77%) had >1 Geriatrics rotation during residency. Residents self-reported lower proficiency scores in competencies related to mobility (3.21) and multicomplexity (3.39). Of the competencies, residents scored lowest in their ability to screen for pressure injuries (2.95) and develop a multifaceted plan for fall prevention (3.00). Our findings highlight gaps in Internal Medicine residents’ self-reported proficiency in key Geriatrics competencies. These results will inform our development of a QR-generated skills tracker for residents to have skills in Geriatrics evaluated in real time by trained faculty. This will also help align curricular content in didactics and rotations to target highest priority learning needs.

  PublisherOA PDFDOI

• Challenges in Health Care for Persons With Multiple Chronic Conditions—Where to Go and How to Get There?

  JAMA Network Open · 2024-10-17 · 15 citations

  articleOpen access
  PublisherOA PDFDOI

• Implementation of a geriatric assessment SmartPhrase: A multi‐institutional pilot study

  Journal of the American Geriatrics Society · 2024-05-10

  articleOpen access

  As the population ages, geriatric assessment (GA) is an increasingly important clinical skill. The GA also encompasses many geriatrics competencies recommended for medical students and internal medicine (IM) and family medicine (FM) residents.1, 2 The geriatric 5Ms offer a succinct framework for key components of a GA3 and are increasingly used in trainee education.4 Note templates in the electronic health record (EHR), called “SmartPhrases” in the Epic EHR, have the potential to improve clinical care, documentation, and education. We created a 5Ms-based SmartPhrase with the goal of improving trainees' familiarity with the GA. We developed a 5Ms-based GA SmartPhrase, incorporating feedback from an informal resident focus group at the University of Pennsylvania (Penn); this original version was used at Penn and Cornell. The SmartPhrase was adjusted per institutional preferences and trainee feedback at Yale; this version was used at Yale. All institutions use Epic EHR. The SmartPhrase (Supplement S1) was implemented on two Acute Care for Elders (ACE) unit rotations (Penn and Yale) and an outpatient Geriatrics rotation (Cornell). ACE unit rotations lasted 2 weeks and the outpatient rotation lasted 1 week as part of a four-week geriatrics block. Trainees included IM, FM, and medicine-pediatrics residents in post-graduate years (PGY) 1 through 4; PGY-1 preliminary residents; and medical students. Trainee composition varied by institution. At the rotation start, trainees received an institution-specific orientation to GA and the SmartPhrase. Orientations were led by geriatric fellows or faculty. Each included an overview of the 5Ms, an introduction to the SmartPhrase, and advice about how to incorporate the SmartPhrase during the rotation, though the delivery format differed (Supplement S2). We conducted voluntary surveys for trainees and involved teaching faculty and geriatrics fellows. Trainees received a pre-survey at rotation start, a post-survey at rotation completion, and a follow-up survey at either 3 months post-rotation or at the end of the academic year (AY). Faculty and fellows received one survey at the AY's end. Trainee pre- and post-survey responses were compared with SAS software v9.4 using unpaired Chi-square or Fischer exact tests when appropriate and a two-tailed significance level of 0.05. Free-text responses were independently coded by three authors, who then met to resolve discrepancies, create a joint codebook, and assign broader themes to the qualitative data. All local Institutional Review Boards deemed the study exempt. Across all three sites, 137 trainees were introduced to the GA SmartPhrase and 101 trainees completed the pre-survey (73.7% response rate). Response rates varied by site (Cornell 17/18; Penn 20/41; Yale 64/78). Respondents included medical students (10.9%), PGY-1 residents (33.7%), and PGY-2 and PGY-3 residents (55.4%). Seventy-six trainees completed the post-survey (55.5% response rate). Response rates varied by site (Cornell 15/18; Penn 22/41; Yale 39/78). Respondents included medical students (11.8%), PGY-1 residents (23.7%), and PGY-2 and PGY-3 residents (64.5%). Forty-eight trainees completed the follow-up survey (35.0% response rate). Response rates varied by site (Cornell 11/18; Penn 15/41; Yale 22/78). Respondents included medical students (6.3%), PGY-1 residents (20.8%), and PGY-2 and PGY-3 residents (72.9%). Respondents reported a significant increase in knowledge of and comfort with GA as well as having a framework for GA (Figure 1A, p < 0.001). Results were consistent across sites and trainee levels (Supplement S3). Most respondents shared that using the GA SmartPhrase impacted clinical practice (Figure 1B). The majority of respondents agreed that using the SmartPhrase was helpful when caring for older adults (94.5%) and planned to use the SmartPhrase in the future (72.9%). Qualitative analysis of post-survey free-text responses suggested that the SmartPhrase facilitated the performance of the GA by providing a user-friendly, thorough, and structured framework with prompts for questions. Respondents felt the SmartPhrase helped with geriatrics learning, patient-centered care, and recognizing the 5Ms. Respondents identified challenges, including a negative impact on workflow. Responses suggested better integrating the SmartPhrase into the rotation curriculum and interdisciplinary workflow of the ACE units (Supplement S4). In the follow-up survey, eight trainee respondents (21.6%) at the inpatient sites indicated using the SmartPhrase in at least one non-geriatrics-specific setting, including other inpatient rotations (10.8%), clinic (16.2%), and home visits (2.7%). At the outpatient site, seven trainee respondents (63.6%) indicated using the SmartPhrase outside of the outpatient geriatrics rotation, including the ACE unit rotation (54.5%), other inpatient rotations (36.4%), and clinic (45.5%). Sixteen faculty and fellows completed the faculty survey (50% response rate). All respondents observed trainees using the GA SmartPhrase and 94% agreed that it is an effective teaching tool. Qualitative analysis of free-text responses suggested that the SmartPhrase facilitated trainee performance of the GA by providing a framework and enhancing consistency and thoroughness, while also standardizing notes and presentations on rounds. Respondents found that the SmartPhrase helped trainees recognize the 5Ms and provide geriatric-specific care. Respondents reported challenges with SmartPhrase completion including inconsistent use, incomplete information, challenges obtaining collateral, and unclear plans for follow-up if incomplete. Respondents also noted a negative impact on workflow, plus a need to enhance trainee education around GA (Supplement S5). In this multi-institutional pilot study, we effectively integrated a GA SmartPhrase into inpatient and outpatient geriatrics rotations, and they remain in use. This was associated with significant improvement in trainee self-reported knowledge of and comfort with performing a GA. Most trainees self-reported an impact on clinical practice, and several trainees reported use beyond their geriatrics rotation, indicating a transfer of knowledge and applicability of the SmartPhrase in other settings. Furthermore, trainees and faculty described complementary benefits of using the SmartPhrase, as well as opportunities for improvement. Strengths of our study include its multi-institutional nature and perspectives from both trainees and faculty. Our findings are limited by possible non-responder bias and differences in SmartPhrases and orientations at each site. Additionally, we were not able to evaluate the change in trainee knowledge and comfort with the GA as a result of each geriatrics rotation, independent of the SmartPhrase. Based on our experience and results, we note several key elements to successfully implement a GA SmartPhrase for educational purposes. First, integration into the rotation curriculum helps to emphasize the importance of the GA and provide basic guidance on the use of the SmartPhrase. Second, SmartPhrase implementation should be tailored to the local needs and context of each institution. Third, the workflow may be impacted by the SmartPhrase itself and by the time it takes to perform and discuss a GA. This should be considered in the design and implementation of a SmartPhrase, and team members may need to embrace flexibility in their personal and teamwork processes. Finally, faculty buy-in is critical for the reinforcing use and providing guidance on the nuances of performing and applying the GA. At the time of the study, JXZ was funded as a Geriatric Medicine Education Fellow by the Connecticut Older Adult Collaboration for Health 4M (COACH 4M) grant. JXZ and JO were supported by a Geriatric Workforce Enhancement Program funded by the Health Resources and Services Administration (HRSA). EBF was supported by a generous donation from the Rosanne H. Silbermann Foundation. The COACH 4M grant, HRSA, and the Rosanne H. Silbermann Foundation had no role in the development of this work or the preparation of this manuscript. All authors met the criteria for authorship stated in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals. Creation of SmartPhrase: JXZ, EPS, RZC, RKM. Acquisition of learners and data: JXZ, EPS, EBF, RZC, JO, LS, RM, RKM. Analysis and interpretation of data: JXZ, EPS, EBF, XZ, DX. Preparation of manuscript: JXZ, EPS. We thank the trainees and faculty members who participated in the implementation of the GA SmartPhrase project. We are especially grateful to Brian Eiss, MD for his efforts in implementing the SmartPhrase at Cornell, to Mark Simone, MD and James Lai, MD for their support of the SmartPhrase on Penn and Yale's ACE units, respectively, and to the Penn and Yale geriatric medicine fellows who provided valuable input regarding the SmartPhrase: Colin Brien, MBBS; Dhruv Jani, DO; Ravneet Randhawa, MD; Julianna Ricco, MD; Rebecca Russell, MD; and Matthew Van Dongen, MD. The authors have no conflicts. At the time of the study, JXZ was funded as a Geriatric Medicine Education Fellow by the Connecticut Older Adult Collaboration for Health 4 M (COACH 4 M) grant. JXZ and JO were supported by a Geriatric Workforce Enhancement Program funded by the Health Resources and Services Administration (HRSA). EBF was supported by a generous donation from the Rosanne H. Silbermann Foundation. The COACH 4 M grant, HRSA, and the Rosanne H. Silbermann Foundation had no role in the development of this work or the preparation of this manuscript. Supplement S1. Geriatric assessment (GA) SmartPhrase examples from each site. Supplement S1a. Instructions for how to create GA SmartPhrase in Epic. Supplement S1b. Downloadable GA SmartPhrase examples. Supplement S2. GA orientation materials from each study site. Supplement S3. Self-reported impact of GA SmartPhrase by trainee level and training site. Supplement S4. Trainee post-survey qualitative themes and representative free-text quotes. Supplement S5. Faculty survey qualitative themes and representative free-text quotes. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

  PublisherOA PDFDOI

• Patient Priorities Care: Priorities Aligned Decision Making for Persons with Multiple Chronic Conditions

  2024-01-01

  book-chapter1st authorCorresponding
  PublisherDOI

• OPTIMIZING CARE OF OLDER ADULTS BY USING 4MS AT A COMMUNITY HEALTH CENTER

  Innovation in Aging · 2024-12-01

  articleOpen access

  Abstract Given the increasing needs of the aging population and limited availability of geriatricians, it is crucial for community healthcare centers to develop effective approaches for geriatric care. Fair Haven Community Health Care, implemented the 4Ms Framework of Age-Friendly Care, from the Institute for Healthcare Improvement for patients 65 and older starting July 2023 at two different clinical sites. We employed screening tools and interdisciplinary team including patient-access, medical assistants, nurses, clinicians and resident physicians, to evaluate cognitive health, mobility, and medication regimens, prioritizing patient-centered care. The Electronic Medical Record was enhanced to include fall risk and cognitive assessments. Feasibility was assessed through surveys. This intervention has been applied to 196 patients, 54% of whom identified as Hispanic, 29% white and 13% African American. A staff survey (N=23) revealed a 100% satisfaction rate, with no adverse effects on workflow. Overall visit times remained consistent, with rooming times for patients under the 4Ms framework increasing by only 11%, indicating no substantial impact on workflow efficiency. Additionally, patient satisfaction increased considerably, with patients reporting a greater sense of involvement in their healthcare decision-making process and felt their care was aligned with their priorities, demonstrating a successful transition to patient-centered care. Thus, we have demonstrated that the 4Ms framework can be integrated into standard care for older adults in a busy community health center. This successful integration highlights our ability to deliver evidence-based care and boost patient involvement, signaling a positive transition towards personalized, patient-centered healthcare delivery for this vulnerable demographic.

  PublisherDOI

• OPTIMIZING CARE OF OLDER ADULTS BY USING 4MS AT A COMMUNITY HEALTH CENTER

  Innovation in Aging · 2024-12-01

  articleOpen access

  Abstract Given the increasing needs of the aging population and limited availability of geriatricians, it is crucial for community healthcare centers to develop effective approaches for geriatric care. Fair Haven Community Health Care, implemented the 4Ms Framework of Age-Friendly Care, from the Institute for Healthcare Improvement for patients 65 and older starting July 2023 at two different clinical sites. We employed screening tools and interdisciplinary team including patient-access, medical assistants, nurses, clinicians and resident physicians, to evaluate cognitive health, mobility, and medication regimens, prioritizing patient-centered care. The Electronic Medical Record was enhanced to include fall risk and cognitive assessments. Feasibility was assessed through surveys. This intervention has been applied to 196 patients, 54% of whom identified as Hispanic, 29% white and 13% African American. A staff survey (N=23) revealed a 100% satisfaction rate, with no adverse effects on workflow. Overall visit times remained consistent, with rooming times for patients under the 4Ms framework increasing by only 11%, indicating no substantial impact on workflow efficiency. Additionally, patient satisfaction increased considerably, with patients reporting a greater sense of involvement in their healthcare decision-making process and felt their care was aligned with their priorities, demonstrating a successful transition to patient-centered care. Thus, we have demonstrated that the 4Ms framework can be integrated into standard care for older adults in a busy community health center. This successful integration highlights our ability to deliver evidence-based care and boost patient involvement, signaling a positive transition towards personalized, patient-centered healthcare delivery for this vulnerable demographic.

  PublisherDOI

Frequent coauthors

• Mary E. Tinetti

  9 shared

• Gregory M. Ouellet

  VA Connecticut Healthcare System

  5 shared

• Marcia C. Mecca

  Yale University

  4 shared

• Cynthia M. Boyd

  Johns Hopkins Medicine

  4 shared

• Ariel R. Green

  Johns Hopkins University

  4 shared

• Aanand D. Naik

  3 shared

• Leah Schecter

  Yale University

  3 shared

• Lea Kiefer

  Baylor College of Medicine

  3 shared

Awards & honors

• Edwin Cadman Teacher of the Year Award for Non-Core Faculty…
• UCSF Tideswell Emerging Leaders in Aging (2019)
• Frederick R. Shell Award (2015)
• Frederick L. Sachs Award (2015)
• UCSF Bechtel Summit Award in Geriatric Medicine (2014)