Introduction: The completeness of medical records is an outstanding problem that affects the quality of health services in many hospitals of Ethiopia. Enhancing the completeness of patients records is inexpensive that can be implemented with the involvement of health workers. Objective: To improve the completeness of patient’s card admitted to Dalefage hospital. Design; Pre - post interventional study from January - August, 2013 GC uses inpatient medical record review form and focus group discussions. Setting; Dalefage district hospital, west Afar, Ethiopia. Participants: Medical director, matron and other clinical staffs. Implementation: The interventions implemented were avail inpatient medical record completeness format, facility based inpatient medical record completeness guideline and procedures were developed and onsite training was provided. The work plan progresses of implementation were monitored by check list. Main outcome measures: Availability of inpatient medical record completeness format, provision of onsite training, development of facility based guideline and procedure and enhancement of inpatient medical record completeness report. Evaluation: inpatient medical record format availability and completeness improved significantly from 0% to 100% and from 0% to 73.6% respectively. Lesson learned: our findings indicate that a well-organized inpatient medical record completeness enhancement can improve the quality of available inpatient information, helps to know our reporting status of inpatient medical record completeness which is crucial to plan improvement strategy and development of facility based guideline and procedure was required to accomplish sustainability. Lastly, onsite training was the best strategy for resource limited countries like Ethiopia to improve health care quality service delivery. Key words: medical record, availability, completeness, Dalefage hospital, Ethiopia