Introduction: Paper-based medical records will remain the norm in many resourcechallenged settings for the foreseeable future. Methods We used a pre- and post- intervention study to measure changes in physician and nurse satisfaction scores, time to locate information in the medical records, and hospital accreditation assessment scores for 21 medical record-related standards. The intervention included using a two-ring binder and divider tabs to organize the inpatient chart and standardizing a set of clinical forms.