Practices need to build audit into their management structure and develop a culture that accepts audit as an essential multidisciplinary or whole team activity. Medical, clinical and administrative audit was made popular in the early 1990s, as a risk management tool that was also clinically and managerially useful. Managers find audit one of the most useful of their managerial tools. Audit is being encouraged by lead organisations. Audit is an objective and systematic way of evaluating the quality of care or service delivery. The aim of internal audit is to examine a particular practice and see whether it can be done better. Audit works best when a group of people decide on something to investigate and improve—ownership of the audit is important. A confidential enquiry is a term often used to describe a significant event audit, where data is collected with an aim to identify the circumstances leading to adverse or unusual events.