Falls have long been one of the leading causes of occupational accidents in the construction industry worldwide. In Taiwan, fall-related fatalities in construction account for as high as 60%–70%, highlighting the urgent need to improve safety measures for working at heights. Although traditional steel-tube scaffolding remains the primary external working platform on construction sites in Taiwan, it still presents limitations in both work convenience and fall protection. In recent years, protection screen systems have been widely adopted in Europe and the United States, providing a fully enclosed work environment that effectively reduces fall risks while improving construction efficiency. This study takes the “Guangci Social Housing Project, Contract C” in Taipei as a case example, where a protection screen system was applied for the first time in place of traditional scaffolding for high-rise exterior wall construction. In April 2022, the research team conducted on-site testing using the Rooti Rx System, a patch-type electrocardiogram recorder, to continuously monitor workers’ heart rate variations under both protection screen and traditional scaffolding environments. This allowed for a quantitative assessment of the physiological workload imposed by the two different construction settings. The results showed that protection screens not only provide significant advantages in terms of safety and construction quality, but also effectively reduce workers’ physiological workload and psychological stress, minimizing heart rate fluctuations caused by fear of heights and work inconvenience. This study demonstrates that protection screen systems can optimize construction environments in terms of safety, efficiency, and sustainability, carrying important implications for reducing occupational accidents in high-rise construction in Taiwan.