Introduction: Medical record chart is a multifunctional document that is used document and torncommunicate information about patients’ health status and medical care to patients and amongrnhealth care professionals.rnProblem statement: In Ayder referral hospital, there is high medical record chart loss.rnObjective: To improve patient’s medical record handling in Ayder referral hospital by reducingrnmedical record chart lost from 5.9% to 3% by the end of July, 2013.rnMethodsrnSetting: Ayder referral hospital located in Mekelle city of Tigray Regional State...rnProject Design: A pre and post intervention was conducted.rnSource population: All medical record charts in the card room.rnTarget population: 3000 medical records. This was registered from October 01, 2005 -rnOctober 21, 2005 E. C in Ayder referral hospital. The study samples were selectedrnsystematically from the target population.rnData collection procedures: Before the data collection using a simple form a one hourrnorientation was given for both data collectors and log book rewriters on the objectives of therncapstone project, ethical issues, and how to use the data collection tools.rnData analysis: The raw data was recorded using paper based system and McNamara’s chisquarerntest was applied.rnSelected intervention: Establishing properly designed medical record chart handoverrnsystem and a team that tries to find lost medical record charts by undergoing room-to-roomrnsearching. This is the best intervention because, it has high political acceptance, takes shorterrntime and the expense incurred for medical record hand over form is low as compare to thernother strategies.rnResult: After implementing the selected strategy, the percentage of medical record chart lossrnwas 17(5.9%) in pre and 9 (3.13%) in the post intervention and the usage of medical record chartrnhandover form was 0% in pre and 100% in the post intervention.rnConclusion: Sustainable usage of well developed handover form during the withdrawal ofrnmedical record chart from the card room and room-to-room searching of medical record chartrnhave a big impact in reducing the loss. Because, it hands them the responsibility.rnRecommendation: Medical record chart handover form should be used when cards are takenrnfrom hospital card room and room-to-room search should be made weekly.