Retention Matters: Translating Outpatient Culturally Responsive Retention Strategies to Emergency Care Teams in...

Outpatient settings, including emergency departments, urgent care centers, and primary care clinics in underserved communities, face persistent workforce instability because of high patient volumes, limited resources, and burnout. This qualitative single-site case study explored retention strategies as perceived by Hispanic Generation Z employees working in a rural primary care clinic near the US-Mexico border. Semi-structured interviews were conducted with 12 medical assistants and analyzed using thematic analysis. Four themes influencing retention emerged: feeling appreciated and recognized, psychologically safe workplace relationships, flexibility with opportunities for professional growth, and cultural affirmation and belonging. Although conducted in an outpatient setting, the findings have conceptual relevance to the broader direct patient-care workforce. Results underscore the importance of relational, cultural, and developmental factors often overlooked in retention strategies that emphasize structural or operational solutions. Culturally responsive approaches may enhance workforce well-being, improve team stability, and support sustainable care delivery in underserved communities.