Falls are a leading cause of harm to older hospital patients. This thesis focused on an under-explored area within the broader field of research, namely the extrinsic causes of inpatient falls. A pair of preliminary exploratory studies yielded two themes for prospective investigation, namely the improvement of inpatient footwear and of hospital night lighting. Subsequent developmental studies ultimately led to a world-first ward-based pilot controlled trial of modified night-lighting. This thesis considerably advances the inpatient fall prevention literature, confirms the feasibility of environmental interventions to reduce falls, and provides a firm foundation for more definitive preventative trials in the future