The Health Information and Quality Authority has given Tallaght hospital in Dublin two weeks to come up with a plan to strengthen management and clinical service issues.
The Governance and Quality Improvement plan is one of three demands HIQA is making of the hospital, following the major X-ray controversy.
It must also establish a central monitoring function for all serious events involving patients, which HIQA will be able to access.
The authority is also demanding the hospital disclose to them any current or future issues of serious concern regarding safety and quality of patient care.
The hospital was embroiled in scandal recently after it was revealed that some 57,000 X-rays went unchecked.
An investigation was launched when hospital chiefs said two patients - one of whom later died and another who is now undergoing cancer treatment – had their diagnoses delayed as a result of the build-up between 2005 and the end of last year.
Hospital management denied reports that up to 30,000 referral letters from GPs had gone unopened, but admitted however that work began in October to clear a backlog of 3,498 letters which had not been reviewed by a consultant.
The revelations prompted the HSE to order a nationwide audit of X-ray procedures in hospitals around the country.
In the wake of the scandal the hospital also moved to overhaul its management structure, slashing the size of its board of management from 22 to 10 and bringing in outside experts and patient representatives.
HIQA Chief Executive Dr Tracey Cooper said in a statement today it was important "that the issues that arose in (the hospital) are reviewed nationally by the HSE, and other providers, to ensure that similar issues do not occur in other hospitals and, where any issues are identified, they are addressed promptly and on a sustainable basis.”
The Authority said it had been in discussions with the Irish College of General Practitioners in relation to the backlog of unprocessed GP patient referral letters that accumulated at the hospital, and would be undertaking a national review of the patient referral process between GPs and Hospitals.
"The aim of this review will be to assess the current arrangements that are in place across the country with the view to making recommendations for a consistent approach nationally that will improve the care and access for patients," the HIQA said.