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ChartRT Career & Professional Practice

Clinical Documentation Formats Compared

SOAP, SOAPIER, SBAR, narrative, charting by exception — the documentation and communication formats RTs use, compared by what each section means and when each fits.

Written by Apex Respiratory Editorial Team

Educational use only. This material supports respiratory therapy education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional protocols, or physician orders. Always follow facility policies and current provider orders, and verify calculations independently before clinical use.

Documentation Formats

Comparison of clinical documentation formats by structure and best use
FormatWhat it stands for or its structureBest use
SOAPSubjective, Objective, Assessment, PlanA structured progress note
SOAPIERSOAP plus Intervention, Evaluation, RevisionA detailed progress note that records response and revision
SBARSituation, Background, Assessment, RecommendationHandoffs, escalation, and verbal or written communication
NarrativeA chronological free-text accountFlexible detail; events and timelines
Charting by exceptionDocuments only deviations from defined normsEfficient routine charting when standards are clear

How to Use This Chart

Each format serves a distinct purpose. Choosing the right one depends on whether you are writing a progress note, communicating a handoff, or charting routine care. Keep the following in mind when applying these formats in practice.

  • SOAP and SOAPIER structure a progress note; SBAR structures communication such as a handoff or escalation — they serve different purposes.
  • Charting by exception is efficient but only safe with well-defined normal standards (an undocumented finding is assumed normal).
  • Whatever the format: document objectively and contemporaneously, and avoid the Do Not Use abbreviations.

Related Resources

Sources

  1. Kacmarek RM, Stoller JK, Heuer AJ. Egan's Fundamentals of Respiratory Care. 12th ed. Elsevier; 2021. Recording and communicating clinical data.
  2. The Joint Commission. Standards for documentation and communication. The Joint Commission.