Objective:To explore perspectives about issues surrounding organizational decisions to adopt and implement medication safety technologies. Methods: Three focus groups and 5 telephone interviews with US hospital pharmacy directors were conducted, representing 25 hospitals. A written survey provided supplemental information about adoption of the technologies. We used one component of Rogers' diffusion of innovation model to guide our study. Results: Pharmacy directors reported different adoption rates for medication safety technologies, with 100% adoption of automated dispensing systems, 36% of electronic medication administration records, 27% of bar code medication administration technology, and 18% of computerized prescriber order entry systems. We explored 6 major themes within our study, with 4 themes suggested by Rogers' model: (1) agenda-setting, (2) matching, (3) redefining, and (4) clarifying. These themes were characterized from discussions on issues such as the importance of patient safety as a motivator for technology adoption; prioritizing implementation of medication safety technologies; choosing a vendor for safety innovations; the need for technology customization; and the need to clarify an innovation's role in addressing patient safety at an institution. Two emergent themes included (5) participants' roles in the innovation process and (6) perspectives about future adoption of medication safety technologies. Conclusion: Understanding the applicability of Rogers' innovation process model can help institutions interested in promoting the adoption of medication safety technologies. Recognizing the variability of different stakeholders' perspectives and appreciating the insight of pharmacy directors may be important for organizations hoping to expand the use of information technology to improve patient safety.