Hospitals are discovering a new customer base: visitors and employees who previously went off-site for their café lattes and panini sandwiches. These people constitute a captive audience that wants something different, and they are willing to pay a higher price for it.

A neon coffee icon greets visitors at Brigham and Women's Hospital's cafeteria in Boston

Healthcare facilities have also discovered that design matters, and nowhere is this truer than in dining areas. These environments must be on par with local “boutique” cafés that have established an upscale, trendy, and energized ambience.

The reality is that hospital cafeterias often lack ambience. They are typically located in inconvenient or hard-to-find locations that have fluorescent lighting and vinyl floors. And even if a cafeteria's atmosphere is improved and customers start pouring in, there must be a good variety of high-quality menu items to keep those customers. Currently, most edibles in hospitals are perceived as “hospital food.”

Some facilities are catching on and have started providing a differentiated food service in an upscale environment to capture a customer base that already exists but didn't have a place to go.

The reasons for developing an upscale hospital café are many and usually include:

  • to enhance customer satisfaction;

  • to increase revenues;

  • to improve efficiencies by offsetting volume from the main cafeteria

  • to educate/promote healthy lifestyle choices.

At Sarasota Memorial Hospital in Sarasota, Florida, the opening of the 1700 South café created a buzz by providing the ambience of a trattoria with its rustic pavers and deep, saturated color palette. This much-needed public amenity also allowed the hospital to capitalize on aligning customer volume to the actual space required to handle that volume. The hospital was able to reduce hours and staff in the main cafeteria and shift that business to the new café during off-peak periods. Using this strategy, Dietary Manager Girard Voilette reported a 15 to 20% overall net increase in revenue because of enhanced efficiencies and increased volume for 1700 South. Visitors and staff were delighted to have an on-site amenity that provided them with a dining experience more akin to their lifestyle.
The option of alfresco dining is offered at Sarasota Memorial Hospital's 1700 South café's sheltered outdoor patio

The Stamford Health System's Daniel and Grace Tully & Family Health Center, a freestanding ambulatory services center in Stamford, Connecticut, features the Heart Smart Café. The café's festive umbrella tables are visible to all as they spill out onto the two-story public circulation spine. Not only does the café enhance customer satisfaction, but its menu also supports the overall mission of a healthy lifestyle.
Sarasota Memorial Hospital's 1700 South features a trattoria image compatible with the menu items

Location Is Everything

The location of a café is critical. Ideally, it should be located along the most heavily trafficked area or adjacent to other popular retail destinations such as the gift shop. However, while these areas offer the most visibility, they are usually remote from existing dietary support services such as the main kitchen, dishwashing area, and loading dock. They also present operational challenges.

Café tables with market umbrellas spill out onto the two-story atrium at the Daniel and Grace Tully & Family Health Center in Stamford, Conn
For example, most cafés opt for premade offerings, as there is usually only enough space to accommodate a prep kitchen. Menu items are typically cold—gourmet sandwiches, salads, and pastries—limiting hot items to beverages and soups. Without a separate dishwashing area, disposable tableware is favored over china and silverware. Bulk storage is limited and usually remote. Trash removal can be the most challenging aspect, given the prominent public location, as most access and removal crosses over public circulation.

Operational Models

Various operational models should be considered, including self-op, franchise/site licensing, and outsourcing. Each has advantages and disadvantages depending on the specific situation.

The self-op model provides the hospital with complete control and ensures that the financial and operational goals are consistent with its own. The advantages include having the flexibility to adjust quickly to market demands, having the ability to customize to suit your customer base, and not having to share revenues (if there are any). Self-op management has complete control over the design, menu, pricing, and staffing. Tom Serafin, director of food services for Concord Hospital in Concord, New Hampshire, chose this model for his hospital's Karner Blue Café, named after a local endangered butterfly, so he could tailor the menu to reflect regional and seasonal tastes.

A new food court was designed within the medical office building and connected atrium area at Baptist Memorial Hospital-Memphis, attracting the public to the independent franchise eating establishments and freestanding vendors
The franchise/site licensing model will vary depending on the specific franchise selected. In general, each one is developed to meet specific market segments or targeted customer types. Traditionally there is little flexibility related to the menu mix and service-level option. Most franchises have strict design requirements that not only outline the look or image but also the square footage requirements. Advantages include brand recognition and consistent quality levels.

The outsourcing model allows you to offer the amenities without any of the management or operational headaches. The Stamford Heart Smart Café was set up according to this model because the location was off-site and the hospital wasn't set up to prepare and transfer food.
Café floor plan at Concord Hospital in Concord, N.H. Rendering courtesy of Gary Kessel/TRO/The Ritchie Organization

Setting the Mood

Healthcare facilities recognize that it is not only the quality and variety of the food that attract the targeted customer but also the environment. Cafés in healthcare facilities must project an upscale image like the off-site competition if they are to attract the targeted customer base. The café should offer a respite from the stress, noise, and visual chaos and should be a place where staff, visitors, and families can go to relax, socialize, and escape the healthcare environment. Some cafés are so successful that clients report that they have off-site customers coming in for their morning coffee on their way to work. So the next time you drive by your local hospital, stop in, order a fresh fruit smoothie, and enjoy the ambience. HD

Joanne MacIsaac, IIDA, is Vice-President/Principal of Interior Design at TRO/The Ritchie Organization (, with offices in Boston, Memphis, Birmingham, and Sarasota.