Warning On Wall (W.O.W.)

What it does

Warning On Wall (W.O.W.) is a wall art installation, informed by the hospital’s digital twin system, that discreetly activates visual and auditory cues to safely distract and delay fall-risk patients from leaving the bed, giving nurses time to assist.

Your inspiration

This project set out to reduce falls among fall-risk patients in hospital wards, particularly during night-time staff shortages. Research into current state-of-the-art revealed that current solutions, such as inflatable vests and fall mats, address falls after they happen. These solutions minimise, and not prevent, injuries. Our challenge, thus, was to design an upstream solution to prevent or minimise falls by distracting or disincentivising at-risk patients, giving nurses extra time to intervene. Inspired by wall decor, we created a discreet, programmable art installation that activates when a fall-risk patient attempts to leave their bed.

How it works

Our design is a wall-mounted, programmable art display powered by an ESP32 microcontroller and a standard wall plug. It connects via Bluetooth to the hospital’s digital twin, which sends and receives text-based commands. When a fall-risk event is detected, an “ALERT” is sent to the ESP32, prompting the LED matrix to flash a red “X” and the DFPlayer Mini MP3 module to play an alert sound through a speaker. The alert is curated to be culturally relevant, attention-grabbing, and clearly audible for the target audience. Nurses are notified via the digital twin’s mobile app, and the display resets with a “RESET” command. The LED matrix is fully programmable, with manual or automatic brightness control via ambient light sensors, and volume/brightness can be scheduled using the digital twin’s real-time clock. By integrating emerging technologies like 3D printing and computer vision with established sensors, we successfully achieved a low-cost, modular design.

Design process

Initial market and state-of-the-art research highlighted a lack of upstream solutions for fall-risk incidents. Interviews with end-users, including nurses and engineers, established key needs: wall-mounted design, ease of maintenance and sterilisation, effective attention capture, integration with surroundings, language neutrality, cultural appropriateness, and low-tech operation. Concept generation was carried out through guided brainstorming, followed by concept screening using peer reviews and AI tools to support visualisation, assess feasibility, and validate concepts. The first prototype projected an “X” onto the bed frame, accompanied by various audio cues: a soft chime, three-tone melody, and tritone melody. However, user testing revealed the projection could be blocked and the audio cues failed to capture elderly patients’ attention. The next iteration used a red flood light on the floor, but concerns arose about light disturbing adjacent patients. The needs criteria were updated to ensure the solution would not startle patients while remaining effective. Critical design elements identified included image type, colour, sound volume and frequency, space constraints, data transfer speed, power consumption, and adaptability to time of day, all reflected in the final design.

How it is different

Most hospital safety solutions focus on fall detection, alerting staff only after a patient has fallen, often too late to prevent injury. Our design offers an upstream solution: fall prevention through environmental intervention. Unlike typical ward systems that notify nurses post-incident, our solution delays the patient through subtle visual and auditory cues, buying critical seconds for nurses to intervene and assist. The design resembles artwork, with an acrylic front panel serving as a canvas for art displays, such as by local artists and words of encouragement, thus minimising technological fatigue and patient stress. The visual and audio cues are customisable and personalisable. By default, the system uses universal symbols and locally-inspired sounds for language neutrality. However, the cues can be tailored to individual needs. No current product offers this non-invasive, preventive response within hospital wards.

Future plans

Our next step is full deployment in every digital twin-enabled ward of Eastern General Hospital by 2030, with plans to scale across the SingHealth network. We aim to adapt the design for at-home and remote care facilities, supporting caregivers amid labour shortages and Singapore’s ageing population. By refining the system for broader use, we hope to establish it as a low-cost, preventive safety standard in both institutional and home settings, bringing smart, dignified care to those who need it most.

Awards