Quality assurance is cyclical and allows or creates the opportunity for continuous review and can be a full 360-degree opportunity for all role players in the system. In order for a quality system to be successful it requires clear criteria and guidelines, but also requires sufficient capacitation, role definition and feedback mechanisms. This paper has considered the importance of a clear understanding of what quality is, but also considers both the role of quality auditors for a regulatory authority. In conclusion, communication in a manner which encourages reflexive opportunities, creating a new way of communicating outside of the “process” driven organizations seems to be the most inclusive and productive manner in which to address conflict in a hierarchical and power based organization. The way in which the auditor creates a mirror to their own practice (reflexive opportunity), communication skills and the manner and circumstances in which they evaluate the stakeholder’s interaction (learning conversations) are the tools, which can ensure productivity of the system. It is imperative to include a reflexive component, which asks all parties to acknowledge their role in the process, to ensure that all sides are acknowledged and that praise is given for participation, language is changed to be more inclusive and supportive and to ensure that the negotiation moves towards the best outcome.