Patients going to Cavan General Hospital for complicated surgery may now be referred to other hospitals, including Our Lady of Lourdes Hospital in Drogheda.
The new protocol follows the investigation of 15 medical cases in which concerns were raised following the death of nine-year-old Cavan girl Frances Sheridan last month, three weeks after she had an operation on her appendix at the hospital.
Her death was not one of the 15 cases and is being investigated separately.
The medical adviser to the North Eastern Health Board, Mr Finbar Lennon, was asked to review the clinical incidents at the hospital's surgical unit between September and December 2003.
In his report Dr Lennon said that all 15 deaths involved "high-risk cases where a significant post-operative morbidity and mortality rate could be anticipated".
But he added that due to the complex clinical-management problems presented by these cases, moving these patients to a hospital with specialist GIT (gastro-intestinal tract) surgical services should have been considered.