Purpose -In the light of strong policy emphasis on quality and safety in the nursing care of patients in hospital settings, this paper focuses on the factors affecting the adoption of innovative quality assurance technologies. Design/methodology/approach -Two sets of complementary literatures were mined for key themes. Next, new empirical insights were sought. Data gathering was conducted in three phases. The first involved contact with NHS Technology Hubs and other institutions which had

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... ts into leading centres in quality assurance technologies. The second phase was a series of telephone interviews with lead nurses in those hospitals which were identified in the first phase as comprising the leading centres. The third phase comprised a series of face to face interviews with innovators and adopters of healthcare quality assurance technologies in five hospital trusts. Findings -There were three main sets of findings. First, despite the strong policy push and the templates established at national level, there were significant variations in the nature and robustness of the quality assurance toolkits that were developed, adapted and adopted. Second, in most of the adopting cases there were important obstacles to the full adoption of the toolkits that were designed. Third, the extent and nature of the ambition of the developers varied dramatically -some wished to see their work impacting widely across the health service; others had a number of different reasons for wanting to restrict the impact of their work. Originality/value -The general concerns about front-line care and the various inquiries into care quality failures emphasise the need for improved and consistent care quality assurance methodologies and practice. The technology adoption literature gives only partial insight into the nature of the challenges; this paper offers specific insights into the factors inhibiting the full adoption of quality assurance technologies in ward-based care.