Almost 50 hospitals will be headed by six independent groups under plans to reform Ireland's acute hospital system, the health minister has said.
James Reilly claimed the plan will modernise the health system and deliver safe and high quality care for patients across the country.
No small hospital will close under the scheme, but some will have specialist services transferred to bigger facilities while gaining more routine surgeries.
Mr Reilly said: "The establishment of hospital groups signals a fundamental modernisation of our health system organisation in line with best international practice.
"The new hospital groups, each with their own governance and management, have been designed so as to provide the optimal configuration for hospitals to deliver high-quality, safe patient care which is cost effective and guarantees better outcomes for patients."
Each group will have between six and 11 hospitals, depending on population and needs, and be centred around large teaching hospitals with links to universities. They will also have its owns chief executive and five other senior officers who will be accountable for the each facility.
There will be three in Dublin, including Dublin North East, headed by Beaumont Hospital; Dublin Midlands led by St James's Hospital, and Dublin East led by the Mater Hospital. Cork University Hospital will head the South/South West group, with the West/North West led by University Hospital Galway and Midwest headed by the Mid-Western Regional Hospital in Limerick.
Professor John Higgins led a group of international experts who devised the plan, which paves the way for the establishment of hospital trusts.
He said: "We have a wonderful opportunity to make a step change within the Irish hospital system. We need to draw down the enthusiasm, the expertise and the experience of our all our staff. Working together we can deliver real change."
Health chiefs said each group of hospitals will work together as a single entity managed as one, providing acute care for patients across the region and integrating community and primary care.