The Joint Commission
Quality Check
Quality Report

Summary of Quality Information
MedStar-Georgetown University Medical Center
DBA: MedStar Georgetown University Hospital
Org ID: 6309
3800 Reservoir Road, Northwest
Washington, DC  20007

Last Full Survey Date Last On-Site Survey Date
Accredited 1/25/2014 1/24/2014   1/24/2014  

Accreditation programs recognized by the Centers for Medicare and Medicaid Services (CMS)

Advanced Certification
Last Full
Review Date
Last On-Site
Review Date
Primary Stroke Center
Certification 10/23/2015  10/22/2015  10/22/2015 

Other Accredited Programs / Services
Hospital  -  Accredited by American College of Surgeons-Commission on Cancer (ACoS-COC)
Laboratory Accreditation Program  -  Accredited by American Society for Histocompatibility and Immunogenetics (ASHI)

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  Symbol Key
This organization achieved the best possible results
This organization’s performance is above the target range/value.
This organization’s performance is similar to the target range/value.
This organization’s performance is below the target range/value.
This measure is not applicable for this organization.
Not displayed
  Footnote Key
1. The measure or measure set was not reported.
2. The measure set does not have an overall result.
3. The number is not enough for comparison purposes.
4. The measure meets the Privacy Disclosure Threshold rule.
5. The organization scored above 90% but was below most other organizations.
6. The measure results are not statistically valid.
7. The measure results are based on a sample of patients.
8. The number of months with measure data is below the reporting requirement.
9. The measure results are temporarily suppressed pending resubmission of updated data.
10. Test Measure: a measure being evaluated for reliability of the individual data elements or awaiting National Quality Forum Endorsement.
11. There were no eligible patients that met the denominator criteria.
National Patient Safety Goals and National Quality Improvement Goals
    Compared to other Joint Commission Accredited Organizations
    Nationwide Statewide
2014 National Patient Safety Goals See Detail
This organization’s performance is similar to the target range/value.
This Goal is not applicable for this organization.
National Quality Improvement Goals:    
Reporting Period:
Oct  2014 -
Sep  2015
Children's Asthma Care See Detail
Not displayed.
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Hospital-Based Inpatient Psychiatric Services See Detail
Not displayed.
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Perinatal Care See Detail
Not displayed.
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Venous Thromboembolism (VTE) See Detail
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National Quality Forum The Joint Commission only reports measures endorsed by the National Quality Forum.
* State results are not calculated for the National Patient Safety Goals.

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Sites and Services
* Primary Location

An organization may provide services not listed here. For more information refer to the Quality Report User Guide .

Locations of Care Available Services
MedStar-Georgetown Medical Center  *
DBA:  MedStar Georgetown University Hospital
3800 Reservoir Road NW
Washington, DC  20007
Joint Commission Advanced Certification Programs:
  • Primary Stroke Center
    • Behavioral Health (24-hour Acute Care/Crisis Stabilization - Adult)
    • Brachytherapy (Imaging/Diagnostic Services)
    • Cardiac Catheterization Lab (Surgical Services)
    • CT Scanner (Imaging/Diagnostic Services)
    • Dialysis Unit (Inpatient)
    • Ear/Nose/Throat Surgery (Surgical Services)
    • EEG/EKG/EMG Lab (Imaging/Diagnostic Services)
    • Gastroenterology (Surgical Services)
    • GI or Endoscopy Lab (Imaging/Diagnostic Services)
    • Gynecological Surgery (Surgical Services)
    • Gynecology (Inpatient)
    • Hematology/Oncology Unit (Inpatient)
    • Inpatient Unit (Inpatient)
    • Interventional Radiology (Imaging/Diagnostic Services)
    • Labor & Delivery (Inpatient)
    • Magnetic Resonance Imaging (Imaging/Diagnostic Services)
    • Medical /Surgical Unit (Inpatient)
    • Medical ICU (Intensive Care Unit)
    • Neuro/Spine ICU (Intensive Care Unit)
    • Neuro/Spine Unit (Inpatient)
    • Neurosurgery (Surgical Services)
    • Normal Newborn Nursery (Inpatient)
    • Nuclear Medicine (Imaging/Diagnostic Services)
    • Ophthalmology (Surgical Services)
    • Orthopedic Surgery (Surgical Services)
    • Orthopedic/Spine Unit (Inpatient)
    • Outpatient Clinics (Outpatient)
    • Pediatric Unit (Inpatient)
    • Plastic Surgery (Surgical Services)
    • Positron Emission Tomography (PET) (Imaging/Diagnostic Services)
    • Post Anesthesia Care Unit (PACU) (Inpatient)
    • Radiation Oncology (Imaging/Diagnostic Services)
    • Sleep Laboratory (Sleep Laboratory)
    • Surgical ICU (Intensive Care Unit)
    • Surgical Unit (Inpatient)
    • Teleradiology (Imaging/Diagnostic Services)
    • Thoracic Surgery (Surgical Services)
    • Transplant Surgery (Surgical Services)
    • Ultrasound (Imaging/Diagnostic Services)
    • Urology (Surgical Services)
    • Vascular Surgery (Surgical Services)

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