As competition surges among healthcare providers, delivering positive experiences for patients is inspiring projects that breathe new life into care spaces. But simultaneously, organizations are turning their attention to areas of the hospital that likewise improve staff and family satisfaction, and few spaces hold the potential to achieve this that the cafeteria does.

“The dining room in the hospital may not be a great source of revenue, but it does serve as an integral cog in the overall well-being and quality of the hospital services,” explains Yi Belanger, designer at Add Inc., which is now with Stantec (Miami). “Patient and family member satisfaction ratings greatly rely on the overall experience of their hospital stay, and oftentimes, it means the hospital’s overall accommodations and service, including their dining space.”

On the flip side, hospitals with outdated dining facilities may suffer from perception coloring reality, leading patients and families to erroneously believe that the hospital itself is outdated.

A vast departure from the traditional single cafeteria line with limited food options and hours of operation, today’s hospital dining areas are designed as comfortable, hospitality-inspired spaces customized for the user experience. Embraced by staff and patient families, these spaces are viewed as a welcome amenity, particularly for those spending extended periods of time in the hospital.

Efficiency and flow
To start, hospitals across the country are attempting to rectify the long-standing inefficiencies in cafeteria flow and service. Traditionally set up based on a lengthy serving line, entry and exit points were often unclear, and wandering patrons commonly threw a wrench in circulation.

To ensure a new space achieves optimal flow and space efficiencies, both in the serving/dining zones and back-of-house areas, Belanger says her team typically interviews the administrative, clinical, and kitchen staff to develop an understanding of workflow patterns in existing dining areas. Based on those conversations, the optimal amount of seating and square footage needed for circulation, serving, and egress emerges.

Another noted trend is breaking up the traditional food service line into multiple stations with varied food offerings: for example, a salad bar, prepackaged to-go meals, sandwich station, and condiment stands. “Signage can be used to effectively guide visitors, but the design team must create a flow that allows guests to visualize the menu offerings, traverse to the desired offering stations, and pay and exit from a controlled space in a minimal time frame. The design must also maximize the number of transactions within a specified time frame,” says David N. Moon, principal of Moon Mayoras Architects (San Diego).

Strategic seating
When it comes to seating arrangements, the key is variety, incorporating options like a bar with stools, larger tables, smaller booths, and outdoor seating, if possible. “I like to create zones in these spaces for serving, dining, lounging, and personal space,” Belanger says. “These spaces can be equipped with movable furniture and modular systems that can be transformed for different functions during work hours and afterwards.”

Cindy Elkin, interior designer at RLF (Orlando), says that seating should support a variety of dining experiences and levels of social interaction. “To distinguish between these areas, we establish a flow of spaces and look at how we can manipulate the ceiling planes, wall boundaries, and seating heights to create spaces that are immediately identifiable as more intimate quiet areas or on-demand, energizing spaces,” she says.

For example, Kalloor recommends half-height walls to partition off small groupings of tables so that the numerous dining seats can be zoned into small compartments. These walls can also double as a barrier to shield these more private seating areas from traffic flow. “Patterned or colorful acrylic panels can also be used to serve as a vertical screen that helps to divide and organize space without the visual weight of a full wall,” she says.

To customize the space to specific user groups, Belanger recommends booth seating for the comfort and privacy of families, and unfixed tables and chairs in small and large clusters to support staff. Although preferences will vary from hospital to hospital, institutions generally require separate dining areas for doctors to support events like staff presentations, physician case studies, and educational programs often occurring during lunchtime. Some institutions may also require private areas for VIPs, such as hospital benefactors, foreign dignitaries, or celebrities.

Mastering materials
As for how healthcare dining areas are being reimagined from an interiors perspective, the options for finishes are endless. “Dining spaces within a healthcare setting are the one place where designers can take more design risks,” says Margi Kaminski, senior associate vice president at RTKL (Chicago).

The materials palette can be much broader than that generally used in other healthcare spaces and may include accents such as high-gloss wall tiles in bold colors or patterned resin panels and textured glass. Kaminski also considers furnishings like sculptured chairs or decorative lighting for dining projects.

However, because dining spaces are housed within a high-use setting, designers must be “extra clever and creative in our material selections,” says Belanger, with furnishings and finishes specified that are durable and easily cleaned. “You want to create a space that performs like a high school cafeteria but looks more like a restaurant,” says Chris Youssef, an associate at Perkins Eastman (New York), “so mosaic tiles, glass, and wood laminates are the go-to materials that will give warmth, durability, and a higher-end look.”

Meanwhile, Belanger likes to introduce a lot of soft fabrics ingrained with stain-resistant properties and that fight wear and tear. Elkin adds visual interest to seating areas through texture, using rough and smooth surfaces to provide a backdrop while still maintaining cleanability and durability.

Kalloor turns to natural materials—in moderation—to finish a space. “While many natural materials may not be suitable for healthcare dining environments due to durability or sterility, when used selectively, they can add a lot of impact.” For instance, ceilings are a good place to incorporate the richness and beauty of wood, while natural stone tiles or glass mosaics can be integrated into the design in small doses and still deliver high design impact.

Another strategy, Kalloor says, is to use synthetic materials that mimic natural materials, colors, and patterns. “Examples include resilient flooring with a natural stone or wood look, engineered surface materials such as quartz or solid surface with visuals that imitate natural stone, and protective wall panels that are treated with a top layer that has an organic texture or wood panel appearance,” she says.

For flooring, Elkin recommends a balance of hard and soft flooring surfaces to create boundaries between different seating clusters and service areas. For example, hard-surface flooring, such as porcelain tiles, are typically installed in high-traffic circulation zones and at food service transition areas. Hard-surface flooring with minimal seams also minimizes crevices that may harbor dirt and germs. Poured composite floors like terrazzo o
ffer can high-end visual appeal and come in a large variety of colors, visual textures, and custom patterns.

Up above
An inherent piece of any dining space is all of the equipment required to operate, but one design trick is to shift attention elsewhere—specifically, up. “Designers use ceiling treatments as an opportunity to create interest and draw the eye up and away from the equipment in the serving areas and away from the cluster of chairs and tables in the dining room,” Kaminski says.

Kalloor adds that thoughtful ceiling design comes with even more benefits: “Ceiling treatments allow a large space to be visually compartmentalized into zones, they contribute the most to the acoustical quality within the space, and they tend be the only plane in the room that does not contain a lot of visual clutter.”

Belanger prefers gypsum ceilings in smaller dining and lounge spaces to create an upscale look, but in most applications specifies a smooth-finished acoustic ceiling tile. In place of standard 2-by-2-inch tiles, Kaminski recommends large-format, 48- by-48-inch options to create a more modern look. Barbara Bouza, managing director and principal at Gensler (Los Angeles), adds that high-performance mineral fiber and fiberglass materials will meet washability, noise level, anti-mold, and antibacterial requirements.

Let light in
Lighting is another area where designers can boost the aesthetics of healthcare dining spaces. Whether it’s recessed down lights, decorative pendants, wall washers, rope lights, or indirect accent lights, there are plenty of options to help set the desired tone. For example, Kaminski says, “Mini-pendants over serving areas add a bit of fun, whereas clusters of drum fixtures in the dining area draw the eye upward to create a focal point above the sea of tables and chairs.”

Another trend Belanger sees is hospitals embracing LED lighting. “They understand that the initial cost is higher, but they save on the lifecycle cost almost immediately by reducing the frequency of maintenance calls to replace these fixtures,” she says. “I always like to give them direct/indirect LED fixtures with no more than 3500K for their general light over the food service and back-of-house areas,” she continues. Essentially, 3500K lighting provides a soft, warm light, whereas 4000K or higher takes on a more clinical/institutional look. With the softer light, a more restaurant-like environment is created.

“In the dining areas, I use recessed LED ‘high hats’ controlled by dimmers for different functions, ambience, and mood. LED decorative sconces and/or pendants make a world of difference in creating drama and appeal in a healthcare dining space. It also takes away the institutional look and makes the space feel like a restaurant,” she adds.

Of course, daylighting is also a desirable feature, driven by both newer energy code requirements and user preferences. “Allowing for daylight is key as this space is primarily used by hospital staff who are working in windowless spaces for much of the day,” Kalloor says. “If possible, the dining room should be designed along at least one exterior wall within the facility so that windows can stream light into the space.” Kalloor also recommends clerestory windows and skylights, in addition to conducting sunlight studies to optimize glazing placement and minimize glare.

Take out
Moving forward, designers can anticipate that hospitals will continue prioritizing their dining areas, particularly given the elevated role that patient families are now playing in the healthcare process.

“With shortages in healthcare staff, specifically nursing, the family plays an important role in the caregiving experience and spends more time than ever in the hospital environment,” Bouza says. “These spaces offer visitors a welcome environment more conducive to working, having coffee, or even a small family meeting. A great dining space makes good business sense.”


Barbara Horwitz-Bennett is a contributing editor for Healthcare Design. She can be reached at



SIDEBAR: Back-of-house basics

Offering a take-away list of back-of-house best practices, food service consultant Richard Dieli of Dieli Murawka Howe (San Diego), suggests the following:

•             Provide kitchen and ancillary spaces space for movement and storage of carts and mobile equipment in a safe and sanitary location.

•             Provide more refrigeration than one thinks will be needed.

•             Create a flow within the kitchen spaces that minimizes employee and mobile equipment cross traffic.

•             Create a flow that allows easy access to refrigeration and storage for employees from all production areas.

•             Install hand sinks in all production areas to promote food safety and reinforce a safe and sanitary work environment.

•             Stay focused on utility costs. Utility and water usage are both deleterious to the environment and have a negative impact on the hospital’s bottom line.

•             Optimize natural light. A pleasant work environment makes a healthier and happy employee, which in turn, will positively affect production.