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Through an investigation of different features of a hospital accreditation system, this study improved the understanding of how top management perceives regulatory control. The study examined how this externally mandated system morphed into a hybrid model integrating two difficult-to-conciliate objectives: compliance and performance. Managers perceive accreditation as enabling if the system supports them in achieving both of these organizational objectives without overly constraining their actions. Although the system was first perceived as coercive due to its restricted adaptability, this view was soon replaced by a more enabling perception because of its comprehensive character and top management’s approach to implementing organizational changes. This study contributes to the enabling control literature by illuminating the importance of organizational learning processes, such as organizing dissonance and constructive dialogue, to explain changes in coercive/enabling perceptions. Combined with greater transparency, these processes help managers direct tensions among actors.JEL codes M41, M48